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APRN Employment Contract Critique
Name xxx
United State University
Course xxx
Professors xxxx
Date xxx
Introduction
Family Nurse Practitioners (FNPs) are nurses who have
advanced training and are usually registered. They work with
other health care professionals to give care that is focused on
the whole family. These types of nurses can work in a variety of
clinical settings, including traditional doctor's offices and
hospitals as well as private homes and clinics. They are known
to lay a high focus on the need for general health promotion and
prevention of infections and to provide treatment for every type
of sickness that affects any community member. As these
individuals seek employment, they are typically expected to
negotiate an employment contract in order to prepare,
investigate, and offer precise and substantial terms. For
instance, these doctors should be able to articulate and explain
in a professional manner why they deserve the remuneration
they are requesting in relation to the anticipated earnings of
their services. Consequently, this paper is a review, analysis,
and evaluation of a sample FNP employment contract based on
the primary aspects included in various contract types.
At JJC medical center, the FNP will help patients deal with
their pain. The contract was quite ambiguous regarding the
family nurse practitioner's responsibilities. The particular ages
of the group receiving pain care were not specified in the
contract. No information was supplied regarding the sort of
analgesia, either opioid or nonopioid, that will be administered
to patients. FNP play a key role in the therapy of severe pain,
and it has been demonstrated that its administration reduces
patients' pain and improves their ability to function (Arends et
al., 2020). More detail about the nurse practitioner's duties
should have been included in the agreement.
Compensations
In the state of California, the annual average salary for the
position of a nurse practitioner is $ 123,111 (Salary.com, 2022).
According to the contract, it is not clear how many years of
experience the FNP has; nonetheless, the annual compensation
that is standard for an FNP in the united states is 116,500
dollars on average (Salary.com, 2022). This contract provides
compensation that is less than the state of California's typical
annual pay. The contract specifies that it will be evaluated after
6 months, but it does not indicate if the salary would be
increased considering the performance.
Travel, Gas, or Mileage Compensations
The contract stipulates that transportation compensation for out-
of-state meetings or education will be supplied if it is necessary
for the practitioner's job. Henceforth, no compensation for
transportation in-state conferences or meetings. This is
comparable to the perks provided by other occupations;
however, some firms offer reimbursement for gas mileage over
a predetermined threshold (He, 2021). Gas or mileage can be
used to describe car allowances. This compensation applies
when a contract permits workers to use their own vehicles, and
the employer reimburses all expenses (He, 2021). The mileage
compensation varies based on the number of miles driven. This
type of perk has a big drawback in that it is impossible to
compute the actual amount of gas spent or to create proper
expenditure reports and logs (He, 2021). In addition, the
cancellation procedure is not included in the contract.
On-Call Time
The contract stipulates that the FNP must be on-call at certain
specified times to fill in for the physician. There is no mention
in the contract regarding whether or not the service provider
will receive additional compensation for being on call. When
someone is required to work on-call, they typically receive
additional remuneration for their time. Additionally, the
provider will be required to work on the weekends, but they will
not receive any additional compensation for their efforts, either
for working overtime or on the weekends. This agreement does
not include the benefits that are provided by other FNP jobs,
such as compensation for working extra hours or being on call.
Bonuses
The payment of an annual bonus will be taken into
consideration, considering the productivity, but the payment of
such a bonus is not guaranteed. In the contract, the FNP's
performance will be judged on how on-time, well-documented,
accurate, and accountable they are.
Duration of Employment and How the Agreement can Be
Altered
The length of the employment contract is set at one year, but
after that period of time has passed, the provider has the
opportunity to extend their contract for an additional five years.
Contracts for a number of occupations that are comparable
typically last for one year and include an option to extend them
for an additional number of years after that. Even though the
contract is only valid for one year, either party might choose to
end it early if the expected requirements are not satisfied.
The agreement might be revised to include the demographic for
which the provider will offer care. Additionally, the conditions
of the agreement regarding reimbursement when on call, putting
in overtime, as well as serving duties on the weekends should
be brought up to date (Duquesne University, 2022).
Additionally, the compensation is lower than the state's typical
annual salary for residents of the same state. It would be
beneficial to raise the compensation in order to make it more
comparable to the opportunities that are now available in the
nearby region.
Responsibility Credentials and Benefits
The contract stipulates that the service provider is responsible
for keeping a license, as this is a condition of the position. The
contract makes no mention of FNP reimbursement for license
renewal. The supplier would also cover the prescribed expenses.
The contract specifies that failing to keep a valid license will
result in suspension or termination from the position.
Compensation for license renewal, as well as prescriptive
expenses, ought to have been included in the agreement since
the provider needs them to carry out the tasks for which they
were contracted (Duquesne University, 2022).
Time Off, Vacations, and Continuing Education
The corporation encourages continuous education and will
compensate FNPs for expenses incurred in furthering their
education. When necessary for further education, housing,
transportation, and meals would also be supplied. In addition,
compensation for professional membership fees will be granted.
The fact that the company encourages its providers to
participate in continuing education is significant not only
because doing so is required for the renewal of the provider's
license but also because doing so gives the provider the
incentive to understand evidence-based recommendations,
which in turn improves the quality of healthcare services which
is being delivered (AANP, 2022).
Providers are paid time off for holidays like New Year's Eve as
well or Christmas day. However, this paid time off is not
counted toward the vacation time of the employee. In the event
that a provider needs to take personal leave for any reason, that
time will be subtracted from the total amount of vacation time
that is available to them.
First-year employees receive 2 weeks of vacation, which
increases to 3 in the third and 4 weeks in the 5th year of
service. A minimum of six weeks' notice is required prior to
vacation approval. This employer provides only 2 weeks of
vacation in the first year is inadequate compared to similar
industries. New FNPs should be given at least 3 or 4 weeks of
vacation (AANP, 2022).
The employer provides health insurance, and the practitioner is
authorized to select the desired health insurance plan. The
provider is also covered by liability insurance; however, it
would fall under the physician's policy. A provider should have
occurrence-based insurance that covers them not only while
they are employed but also after they have left their current
position (AANP, 2022).
Restriction on Competition
The employer enforces the non-compete clause to prevent the
employee from using the particular pain management skills they
have gained at a neighboring competitor's facility. The goal of
the competition policy is to prohibit the hospital from exposing
an excessive amount of information about its operations in order
to give an edge to its competitors (AHLA, n.d.). The non-
compete agreement that is used by JJC health center is one of
the laxest in the industry because it permits foregoing
employees to work anywhere outside of a 50-mile effective
range. Nevertheless, the clause permitting NPs to treat
corporation-affiliated patients should be lenient. In a rule that
seems unnecessary, the clause says that the NPs cannot take
patients from the company and find new ones for themselves
within two years after the contract ends. Patients are emotional
creatures similar to everyone else and could form a favorable
attachment to the NP (Arends et al., 2020). People should not be
denied access to the practice of their choice, regardless of
where that NP is located.
Reasons for Termination
A sad fact about a contract is that it can be dissolved if certain
requirements are not satisfied by any party involved. At JJC
medical term, the agreement can be dissolved for a range of
reasons such as a violation of its provisions by either side, the
NP's performance, the employer's financial situation, or the
NP's desire to leave the practice for individual matters. If any
side wishes to end the deal, they must provide a written
explanation within sixty days. The rule ought not to be followed
in this instance since the worker could be abandoning the job
due to an unexpected emergency. However, if the employee's
actions endanger the health and safety of patients, waiting 60
days to terminate the employee may be unjust to JJC health
center. Failure to follow the HIPAA rules, which puts patients
and employers at risk, is a serious issue that needs to be fixed
right away.
The Extent of Support Service to be Offered
Organizations should endeavor to offer NPs ample chances and
support. The JJC medical center offers educational seminars to
further the practice of pain treatment. The company will benefit
greatly from the NPs' increased knowledge since they will
provide excellent care for patients. On the contrary, one could
contend that financing the NP's continued education could be
counterproductive, as the NP may quit after completing their
degree. In this case, the employer would have endured a loss.
Additionally, the organization should endeavor to provide more
transportation options for employees. Most companies offer
transport services for their workers (AANP, 2022).
Furthermore, extra support services should be introduced to
help employees love their work and remain at their workplace
(AANP, 2022). For NPs with babies and toddlers, additional
amenities should include complimentary meals and a daycare
center. As a result, NPs will be motivated to do their best work
on a regular basis since they will feel appreciated.
Expectations of the Number of Patients to be seen Per Day
On average, it is estimated that the NP should examine 20
patients per day. Less than twenty patients per day would imply
that the service is not sufficiently profitable (Weber, 2019).
When designating a number, the organization should be acutely
conscious of the condition of its personnel and mindful of their
wellbeing. The agreement should be clear and fair when it
comes to the number of patients that can be seen on a given day.
The first step in determining a suitable number of patients is
determining how many patients a nurse practitioner may safely
manage in a day (Weber, 2019). The subsequent step is to assess
how many clients can be evaluated in 9.5 hours, given logistical
constraints (Weber, 2019). The JJC health center needs 9 hours
of community service from Monday to Friday. In addition to
this, the organization needs to consider the patients' mobility,
the extent of their communication skills, and the operational
configuration of the hospital.
Expectations Considering Non-Clinical Work
Non-clinical work-related tasks can be performed by NPs at
their location of employment. Non-clinical roles help to achieve
organizational goals (Brom et al., 2018). They could assist in
clinical research. Clinical research aids the hospital in
developing innovative approaches to resolving problems and
enables the NP to increase their knowledge base (Brom et al.,
2018). Positively, given that both parties expect to gain, this
might be termed a win-win situation. On the other hand, the
nurse is pressured to execute activities in which they lack
experience, leading to inaccuracies. The JJC healthcare system
requires NPs to provide secretarial assistance. They can also
serve in administrative capacities, such as receptionist or scribe
duties, or even as patient advocates or advocates for the
underserved.
Quality Performance
The Practitioners should be evaluated in order to improve their
performance on the job. Acknowledging and correcting NPs'
shortcomings is one of the main goals of the evaluation process
(Arends et al., 2020). The contract stipulates that completeness,
accountability, correctness, and compliance must be considered
throughout the evaluation of an NP's performance. However, the
company must give all the necessary tools for the completion of
these responsibilities in order to avoid being perceived as
hypocritical and asking too much of the NPs. Every nurse
practitioner should receive an individual answer from a health
plan auditor, highlighting the areas in which they need to work
on (Arends et al., 2020). Each nurse practitioner should have a
clear annual plan detailing their professional goals for the
future year, which auditors are responsible for ensuring they
have. Overall, the method of releasing excellent performance
data should be consistent and non-coercive so that NPs feel that
they are an integral part of the business (Arends et al., 2020). If
the NPs are handled well during the process, they will try to
follow the published guidelines.
To conclude, an attorney should be brought in to analyze any
and all contracts to ensure that any anomalies are found and that
the deal is fair. For the price of seeking legal advice to review
the contract, studies show this service can be invaluable in
helping NPs better understand their contracts and help them
negotiate new contracts or revise old ones. As with all NPs
contracts that are unique, the second set of eyes can help ensure
that both sides are getting what they want out of this agreement.
This contract, too, appears to have emphasized and explored
essential aspects in great depth.
References
AANP. (2022).
Employment negotiations. American Association of
Nurse Practitioners. https://www.aanp.org/practice/practice-
management/employment-negotiations
AHLA. (n.d.). Ama-Assn.Org. https://www.ama-
assn.org/sites/ama-assn.org/files/corp/media-
browser/public/ama-foundation/legal-operational-guide-free-
medical-clinics.pdf
Arends, R., Anderson Elverson, C., Pike Keefner, T., & Mylant,
M. (2020). Screening, brief intervention, and referral to
treatment training for family nurse practitioner students.
Journal of the American Association of Nurse
Practitioners,
33(5), 375–382.
https://doi.org/10.1097/JXX.0000000000000423
Brom, H. M., Salsberry, P. J., & Graham, M. C. (2018).
Leveraging health care reform to accelerate nurse practitioner
full practice authority.
Journal of the American Association of Nurse
Practitioners,
30(3), 120–130.
https://doi.org/10.1097/JXX.0000000000000023
Duquesne University. (2022, May 26).
How to negotiate a nursing salary. Duquesne University
School of Nursing. https://onlinenursing.duq.edu/blog/nurse-
practitioner-contract-negotiation/
He, T. (2021, March 4).
Medical mileage deduction: Everything you need to
know. TripLog. https://triplogmileage.com/small-
business/everything-you-need-to-know-about-the-medical-
mileage-deduction/
Personal Support Worker HQ. (n.d.).
Nurse practitioner salary in California explained
(2022). Personalsupportworkerhq.Com.
https://personalsupportworkerhq.com/california-nurse-
practitioner-salary/
Salary.com. (2022).
Nurse Practitioner salary in California City, CA.
Salary.Com.
https://www.salary.com/research/salary/benchmark/nurse-
practitioner-salary/california-city-ca
Weber, D. O. (2019).
How Many Patients Can a Primary Care Physician
Treat? Physicianleaders.Org.
https://www.physicianleaders.org/news/how-many-
patients-can-primary-care-physician-treat
Appendix
Nurse Practitioner Employment Contract
EMPLOYER: JJC medical center
TERMS OF EMPLOYMENT
DURATION
The contract duration is for one year with an option for renewal
for five (5) years thereafter.
COMPENSATION
Salary:
The contracted position will be paid at a salary rate of $105,000
per year.
The contract will be renewed the sixth month after a review of
the employee’s performance. Paychecks will be issued
biweekly.
Bonuses:
The consideration of a bonus will be determined yearly based
upon the assessment of the productivity, performance review,
and financial status of the Corporation. There will be no
guarantee of bonus payment, however, the Corporation
maintains the philosophy that the value of an employee must be
assessed, and the reward for the production of a job wel l done
should be recognized with a financial reward.
TERMINATION
The termination of this contract may be made under the
following conditions.
Violation of State or Federal Law Breach of the Contract by
either Party Performance of the NP
Desire to Leave the Practice for Personal Reasons Financial
Considerations of the Corporation
In the event party desires to dissolve the agreement, they should
provide the reason for the dissolution in writing to the other
party with a minimum of 60 days’ notice. In the event an
unreconcilable condition arises between the parties which
cannot be resolved within this time frame, the parties may seek
mediation to resolve the time parameter differences for the
dissolution of the contract for employment.
Immediate termination with cause may be made if there exist
any legal or material impediments to the delivery of patient care
by the NP which may include conditions that would potentially
jeopardize the safety of the patients or place the corporation at
unexpected financial or legal risk
NON-COMPETE CLAUSE
Because of the special skills and information regarding pain
management which would be gained by the NP through
employment, it is necessary to invoke a non-compete agreement.
In the event of dissolution or termination of the contract, the
following non-compete clause shall begin and remain in effect
for two years. The NP shall not maintain or be employed in the
Practice of Pain Management within a 50-mile radius of any of
the corporation’s clinical practice locations. The NP may
continue to practice in these areas; however, the total
percentage of patients being seen for pain management in any
subsequent practice of the NP will not exceed 10 (ten) percent.
The NP shall not during the two-year period following
termination of the contract with the corporation divert, coerce,
or recruit patients involved in the medical practice of the
corporation.
For the two-year period after termination of the contractual
agreement with the corporation, the NP will refrain from the
treatment of all patients seen at the corporation either
individually or collectively, unless otherwise agreed to by the
corporation in writing.
PERFORMANCE EVALUATION
Annual performance evaluation of the NP shall be given for the
purpose of improvement of the NP performance in the
workplace. This evaluation shall include but is not limited to
the review of 5% of the patient electronic medical records of the
NP by the physicians of the practice for the following
information:
*Completeness
*Accuracy
*Accountability
*Compliance with applicable State and Federal Guidelines
regarding prescriptive issues
The second component of the evaluation will include input from
co-workers regarding interoffice communication, flexibility,
and overall personability.
The third component of the evaluation will include a self-
assessment and the creation of an annual plan regarding
professional goals for the upcoming year.
ON-CALL RESPONSIBILITIES
The corporation may request the availability of the NP when the
Physician is out of town for the purpose of providing emergent
patient assessment and referral. These On-Call scenarios should
be planned with the NP. The mutual goal of maintaining 24
hours a day, 7 days a week patient care shall be considered the
most important issue in the vigilance of consistent patient care.
The physician shall be available for telephone consultation at
all times to the NP in the event that the
NP is on-call. The Physician will provide the NP with the
information necessary to contact him during these time periods.
The corporation defines the purpose of an On-Call NP as to
provide emergent patient assessment and treatment only.
The calling in of Prescriptive medication has been and will
continue to be deferred to a scheduled appointment, noting it is
the responsibility of the patient to maintain his/her medications
at an appropriate quantity through planned scheduled
appointments.
ASSISTANCE: SECRETARIAL SUPPORT
The corporation will staff the offices Monday through Friday,
from 8:00 am to 4:30 p.m. The duties and responsibilities of the
office personnel are to maintain patient assistance at check-in,
telephone handling, patient scheduling, and the direction of
patient flow through the clinic day. See the delineation of office
duties in the job descriptions of the following:
HOURS
The hours of employment are as follows:
Monday through Friday 8:00 am to 4:30 p.m.
Saturday – hours to be arranged with mutual consent to
accommodate the patient population and not paid at an
additional rate. Saturday hours are only scheduled when it is
deemed necessary by the President to accommodate the patient
load and not as a regular event. Saturday hours will be no more
than once per month and arranged with the consideration of the
employee request given the request has been made is
reasonable, reflecting the consideration of the office needs.
The position will be paid at a salaried rate with the expectation
that the hours worked reflect full- time employment and may
require more than 40 hours. Those hours worked beyond a 40-
hour
workweek will not be paid at any additional rate, however,
deference will be given to the NP in that overall the average
workweek for the year will be 40 hours.
HOLIDAYS
Paid time off for all salaried employees includes the following
days which are not computed as a vacation.
1. NEW YEAR’S DAY
2. MEMORIAL DAY
3. JULY 4 TH (Except when it occurs on a Saturday or Sunday
then the holiday will be observed on either Friday or Monday)
4. LABOR DAY
5. THANKSGIVING DAY AND THE DAY AFTER
6. CHRISTMAS EVE
7. CHRISTMAS DAY
8. HALF A DAY- NEW YEAR’S EVE
SICK LEAVE
In the event of an acute illness, reasonable notice should be
given to the employer. The primary practice physician should be
contacted personally either at his home or by pager. Excessive
calls concerning the use of unscheduled time off for repeated
illnesses require the documentation of your Primary Care
Physician. The allowable yearly maximum will be no more than
4 days. If the illness requires hospitalization, surgery, or other
medical intervention requiring recovery time suggested by the
Physician rendering the care he/she should convey these
medical requirements to the primary practice physician in
writing within one month of the planned medication
intervention. More than 4 days of unscheduled time off for
illness will result
in the use of paid vacation days to be used for the occurrences.
When the vacation days are exhausted then reduction of benefits
and /or dismissal will be reviewed on an individual basis giving
consideration of the circumstances and the demands of the
practice.
VACATION
First-year of employment two weeks of vacation will be
included in the salaried employee benefits plan.
The salary will include the vacation benefit and no additional
monetary benefit will be paid. In the third year of employment,
the addition of the third week of vacation will accrue.
In the fifth year of employment, the addition of the fourth week
of vacation will accrue. Vacation time will be scheduled with a
minimum notice of 6 weeks, the more notice given to the
designee of the corporation will be greatly appreciated for the
adjustment of patient and physician schedules. The vacation
times request should be made in writing to the corporation and
include the complete dates of your request including weekday
and weekend dates. All reasonable requests will be considered,
and approval of the requested vacation time will be made
available to the employee within one week of submitting the
written request.
PERSONAL LEAVE
Request for personal leave will be considered and vacation time
will be used for the requested days off.
Request for unpaid time off may be considered if there is no
significant interruption in inpatient care and does not pose a
significant burden to the daily operation of the corporation.
CONTINUING EDUCATION
The corporation is committed to the continuation of educational
endeavors within the realm of Pain Management. The
corporation will schedule educational seminars for the
advancement of
the employee in the practice. Should the employee desire to
attend an educational offering unrelated to the practice of Pain
Management sufficient course information should be submitted
to the corporation for review and approval.
The corporation will cover the cost inclusive transportation,
lodging, and meals for Continuing Education for one week for
the purpose of Continuing Medical Education.
PROFESSIONAL MEMBERSHIPS
Memberships to Professional organizations are not a condition
of employment, however, it is expected certain key
organizations and certifications should be achieved from time to
time by the NP as evidence of both professional advancement
and continuing education. The corporation will review
memberships to such organizations and corporate funding will
be allocated through an application process. Submit the required
documentation for the requested organization including the
nature of the membership and associated fees.
LICENSES RENEWAL
Current Indiana License is required prior to employment and
will be verified by the Management. It is the responsibility of
the employee to maintain his/her current Indiana License and
submit a copy of the document prior to gainful employment.
Failure to maintain this documentation as current will
necessarily result in immediate cessation of salary and benefits
until corrections are made.
Payment for Health Professions Bureau fees will be issued to
this agency by the corporation.
PRESCRIPTIVE FEES
All state and federally regulated prescriptive fees and
documentation of DEA and state narcotic licenses are a
condition of employment and must be submitted to the
Management prior to
employment for verification. Current copies of these documents
shall be kept on file for immediate review at all times.
Payment for Health Professions Bureau “Prescriptive Authority
Advanced Practice Nurse” will be issued to this agency by the
corporation. The following are included Prescriptive authority,
controlled substances registration fees, and DEA licensure
verification.
COMMUNICATION
Communication devices will be supplied by the Corporation and
will remain property of said Corporation for the duration of
employment. The devices provided shall not be used for
personal communication and shall be returned to the employer
upon departing from the Corporation. It is the responsibility of
the employee to maintain the equipment in good condition and
report any defects, problems, or malfunction.
Repairs and replacement of the device will be the responsibility
of the Corporation.
TRANSPORTATION
Transportation will be the responsibility of the employee.
Transportation will only be provided when the employee is out
of town for the purpose of attending a meeting, conference, and
or education offering required by the Corporation. All receipts
of the transportation will be required for reimbursement by the
Corporation. Transportation should be arranged prior to the
travel and an estimation of the cost and duration made at that
time. When at all possible the Corporation will make these
reservations and provide the information concerning the
transportation prior to departure to the traveling parties.
Transportation to the satellite offices will be the responsibility
of the employee. Dependable transportation is an expectation
for employment.
INSURANCE
Medical Insurance:
The employee within the financial parameters defined by the
Corporation may determine the type of plan selected. The plan
identified by the employee should be submitted to the
Corporation for review.
The information to be submitted to the Corporation should
include the type of plan, cost, and a contact person with the said
insurance company.
Malpractice Insurance:
The employee will be carried on the primary physician’s
Medical Malpractice Insurance for the duration of their
employment. It is the option of the NP to purchase at their own
expense, separate malpractice coverage.
The Following Malpractice Insurance Company should be able
to answer any question you may have concerning the policy.
Upon employment, the Corporation will provide a copy of the
updated edition of the employee’s coverage.
PROFESSIONAL ISSUES
The corporation will bill the Nurse Practitioner’s fees for the
duration of the contractual agreement. It will be the
responsibility of the employee to properly code the patient
superbill on the electronic medical record computer software.
Training on the system will be provided to the employee.
Information Systems Security Agreement shall be signed
between the employee and the Corporation.
The corporation shall maintain sole ownership of any and all
patient charts, mailing lists, and electronic – computerized
information concerning patient data. The use of said
information
outside the practice shall be construed as a violation of the
Patient’s HIPPA. rights and shall be prosecuted as such.
Promotion of the Company:
The employee shall represent the Corporation in a professional
manner and as a representative of the company, the following
methods of advertising may be employed for the continued
promotion of our corporate philosophy.
Newspaper Advertisements Business Cards
Misc. other printed materials to promote the business for the
general public.
The inclusion of the employee’s name and credentials may be
used in the promotion of the Corporation.
The employee shall have the opportunity to review all material
that contains his/her professional /personal identification. The
employee written and/or verbal approval should be obtained in a
reasonable time for the printing of the material. Objections or
suggestions for the material will be given careful consideration
prior to printing.
Promotion of the corporation may require the attendance of
various local and regional activities. The Nurse Practitioner
may be asked to participate in the activity. The coordination of
such events will be made with the approval and availability of
the Nurse Practitioner. The NP should make an attempt to attend
these functions given ample time and space in the schedule.
Weekend events should be scheduled in advance and
coordinated with the NP. Weekend promotional commitments
are not mandatory and will not influence the practitioner’s
employment status with the corporation.
COOPERATIVE AGREEMENT
The primary physician of the practice or any designated legal
physician agent of the corporation will execute a cooperative
agreement for the purpose of satisfying legal requirements for
the continuing practice of the NP
22APRN Employment Contract CritiqueName xxxU

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22APRN Employment Contract CritiqueName xxxU

  • 1. 22 APRN Employment Contract Critique Name xxx United State University Course xxx Professors xxxx Date xxx Introduction Family Nurse Practitioners (FNPs) are nurses who have advanced training and are usually registered. They work with other health care professionals to give care that is focused on the whole family. These types of nurses can work in a variety of clinical settings, including traditional doctor's offices and hospitals as well as private homes and clinics. They are known to lay a high focus on the need for general health promotion and prevention of infections and to provide treatment for every type of sickness that affects any community member. As these individuals seek employment, they are typically expected to negotiate an employment contract in order to prepare, investigate, and offer precise and substantial terms. For instance, these doctors should be able to articulate and explain in a professional manner why they deserve the remuneration they are requesting in relation to the anticipated earnings of their services. Consequently, this paper is a review, analysis, and evaluation of a sample FNP employment contract based on
  • 2. the primary aspects included in various contract types. At JJC medical center, the FNP will help patients deal with their pain. The contract was quite ambiguous regarding the family nurse practitioner's responsibilities. The particular ages of the group receiving pain care were not specified in the contract. No information was supplied regarding the sort of analgesia, either opioid or nonopioid, that will be administered to patients. FNP play a key role in the therapy of severe pain, and it has been demonstrated that its administration reduces patients' pain and improves their ability to function (Arends et al., 2020). More detail about the nurse practitioner's duties should have been included in the agreement. Compensations In the state of California, the annual average salary for the position of a nurse practitioner is $ 123,111 (Salary.com, 2022). According to the contract, it is not clear how many years of experience the FNP has; nonetheless, the annual compensation that is standard for an FNP in the united states is 116,500 dollars on average (Salary.com, 2022). This contract provides compensation that is less than the state of California's typical annual pay. The contract specifies that it will be evaluated after 6 months, but it does not indicate if the salary would be increased considering the performance. Travel, Gas, or Mileage Compensations The contract stipulates that transportation compensation for out- of-state meetings or education will be supplied if it is necessary for the practitioner's job. Henceforth, no compensation for transportation in-state conferences or meetings. This is comparable to the perks provided by other occupations; however, some firms offer reimbursement for gas mileage over a predetermined threshold (He, 2021). Gas or mileage can be used to describe car allowances. This compensation applies when a contract permits workers to use their own vehicles, and the employer reimburses all expenses (He, 2021). The mileage compensation varies based on the number of miles driven. This type of perk has a big drawback in that it is impossible to
  • 3. compute the actual amount of gas spent or to create proper expenditure reports and logs (He, 2021). In addition, the cancellation procedure is not included in the contract. On-Call Time The contract stipulates that the FNP must be on-call at certain specified times to fill in for the physician. There is no mention in the contract regarding whether or not the service provider will receive additional compensation for being on call. When someone is required to work on-call, they typically receive additional remuneration for their time. Additionally, the provider will be required to work on the weekends, but they will not receive any additional compensation for their efforts, either for working overtime or on the weekends. This agreement does not include the benefits that are provided by other FNP jobs, such as compensation for working extra hours or being on call. Bonuses The payment of an annual bonus will be taken into consideration, considering the productivity, but the payment of such a bonus is not guaranteed. In the contract, the FNP's performance will be judged on how on-time, well-documented, accurate, and accountable they are. Duration of Employment and How the Agreement can Be Altered The length of the employment contract is set at one year, but after that period of time has passed, the provider has the opportunity to extend their contract for an additional five years. Contracts for a number of occupations that are comparable typically last for one year and include an option to extend them for an additional number of years after that. Even though the contract is only valid for one year, either party might choose to end it early if the expected requirements are not satisfied. The agreement might be revised to include the demographic for which the provider will offer care. Additionally, the conditions of the agreement regarding reimbursement when on call, putting in overtime, as well as serving duties on the weekends should be brought up to date (Duquesne University, 2022).
  • 4. Additionally, the compensation is lower than the state's typical annual salary for residents of the same state. It would be beneficial to raise the compensation in order to make it more comparable to the opportunities that are now available in the nearby region. Responsibility Credentials and Benefits The contract stipulates that the service provider is responsible for keeping a license, as this is a condition of the position. The contract makes no mention of FNP reimbursement for license renewal. The supplier would also cover the prescribed expenses. The contract specifies that failing to keep a valid license will result in suspension or termination from the position. Compensation for license renewal, as well as prescriptive expenses, ought to have been included in the agreement since the provider needs them to carry out the tasks for which they were contracted (Duquesne University, 2022). Time Off, Vacations, and Continuing Education The corporation encourages continuous education and will compensate FNPs for expenses incurred in furthering their education. When necessary for further education, housing, transportation, and meals would also be supplied. In addition, compensation for professional membership fees will be granted. The fact that the company encourages its providers to participate in continuing education is significant not only because doing so is required for the renewal of the provider's license but also because doing so gives the provider the incentive to understand evidence-based recommendations, which in turn improves the quality of healthcare services which is being delivered (AANP, 2022). Providers are paid time off for holidays like New Year's Eve as well or Christmas day. However, this paid time off is not counted toward the vacation time of the employee. In the event that a provider needs to take personal leave for any reason, that time will be subtracted from the total amount of vacation time that is available to them. First-year employees receive 2 weeks of vacation, which
  • 5. increases to 3 in the third and 4 weeks in the 5th year of service. A minimum of six weeks' notice is required prior to vacation approval. This employer provides only 2 weeks of vacation in the first year is inadequate compared to similar industries. New FNPs should be given at least 3 or 4 weeks of vacation (AANP, 2022). The employer provides health insurance, and the practitioner is authorized to select the desired health insurance plan. The provider is also covered by liability insurance; however, it would fall under the physician's policy. A provider should have occurrence-based insurance that covers them not only while they are employed but also after they have left their current position (AANP, 2022). Restriction on Competition The employer enforces the non-compete clause to prevent the employee from using the particular pain management skills they have gained at a neighboring competitor's facility. The goal of the competition policy is to prohibit the hospital from exposing an excessive amount of information about its operations in order to give an edge to its competitors (AHLA, n.d.). The non- compete agreement that is used by JJC health center is one of the laxest in the industry because it permits foregoing employees to work anywhere outside of a 50-mile effective range. Nevertheless, the clause permitting NPs to treat corporation-affiliated patients should be lenient. In a rule that seems unnecessary, the clause says that the NPs cannot take patients from the company and find new ones for themselves within two years after the contract ends. Patients are emotional creatures similar to everyone else and could form a favorable attachment to the NP (Arends et al., 2020). People should not be denied access to the practice of their choice, regardless of where that NP is located. Reasons for Termination A sad fact about a contract is that it can be dissolved if certain requirements are not satisfied by any party involved. At JJC medical term, the agreement can be dissolved for a range of
  • 6. reasons such as a violation of its provisions by either side, the NP's performance, the employer's financial situation, or the NP's desire to leave the practice for individual matters. If any side wishes to end the deal, they must provide a written explanation within sixty days. The rule ought not to be followed in this instance since the worker could be abandoning the job due to an unexpected emergency. However, if the employee's actions endanger the health and safety of patients, waiting 60 days to terminate the employee may be unjust to JJC health center. Failure to follow the HIPAA rules, which puts patients and employers at risk, is a serious issue that needs to be fixed right away. The Extent of Support Service to be Offered Organizations should endeavor to offer NPs ample chances and support. The JJC medical center offers educational seminars to further the practice of pain treatment. The company will benefit greatly from the NPs' increased knowledge since they will provide excellent care for patients. On the contrary, one could contend that financing the NP's continued education could be counterproductive, as the NP may quit after completing their degree. In this case, the employer would have endured a loss. Additionally, the organization should endeavor to provide more transportation options for employees. Most companies offer transport services for their workers (AANP, 2022). Furthermore, extra support services should be introduced to help employees love their work and remain at their workplace (AANP, 2022). For NPs with babies and toddlers, additional amenities should include complimentary meals and a daycare center. As a result, NPs will be motivated to do their best work on a regular basis since they will feel appreciated. Expectations of the Number of Patients to be seen Per Day On average, it is estimated that the NP should examine 20 patients per day. Less than twenty patients per day would imply that the service is not sufficiently profitable (Weber, 2019). When designating a number, the organization should be acutely conscious of the condition of its personnel and mindful of their
  • 7. wellbeing. The agreement should be clear and fair when it comes to the number of patients that can be seen on a given day. The first step in determining a suitable number of patients is determining how many patients a nurse practitioner may safely manage in a day (Weber, 2019). The subsequent step is to assess how many clients can be evaluated in 9.5 hours, given logistical constraints (Weber, 2019). The JJC health center needs 9 hours of community service from Monday to Friday. In addition to this, the organization needs to consider the patients' mobility, the extent of their communication skills, and the operational configuration of the hospital. Expectations Considering Non-Clinical Work Non-clinical work-related tasks can be performed by NPs at their location of employment. Non-clinical roles help to achieve organizational goals (Brom et al., 2018). They could assist in clinical research. Clinical research aids the hospital in developing innovative approaches to resolving problems and enables the NP to increase their knowledge base (Brom et al., 2018). Positively, given that both parties expect to gain, this might be termed a win-win situation. On the other hand, the nurse is pressured to execute activities in which they lack experience, leading to inaccuracies. The JJC healthcare system requires NPs to provide secretarial assistance. They can also serve in administrative capacities, such as receptionist or scribe duties, or even as patient advocates or advocates for the underserved. Quality Performance The Practitioners should be evaluated in order to improve their performance on the job. Acknowledging and correcting NPs' shortcomings is one of the main goals of the evaluation process (Arends et al., 2020). The contract stipulates that completeness, accountability, correctness, and compliance must be considered throughout the evaluation of an NP's performance. However, the company must give all the necessary tools for the completion of these responsibilities in order to avoid being perceived as hypocritical and asking too much of the NPs. Every nurse
  • 8. practitioner should receive an individual answer from a health plan auditor, highlighting the areas in which they need to work on (Arends et al., 2020). Each nurse practitioner should have a clear annual plan detailing their professional goals for the future year, which auditors are responsible for ensuring they have. Overall, the method of releasing excellent performance data should be consistent and non-coercive so that NPs feel that they are an integral part of the business (Arends et al., 2020). If the NPs are handled well during the process, they will try to follow the published guidelines. To conclude, an attorney should be brought in to analyze any and all contracts to ensure that any anomalies are found and that the deal is fair. For the price of seeking legal advice to review the contract, studies show this service can be invaluable in helping NPs better understand their contracts and help them negotiate new contracts or revise old ones. As with all NPs contracts that are unique, the second set of eyes can help ensure that both sides are getting what they want out of this agreement. This contract, too, appears to have emphasized and explored essential aspects in great depth. References AANP. (2022). Employment negotiations. American Association of Nurse Practitioners. https://www.aanp.org/practice/practice- management/employment-negotiations AHLA. (n.d.). Ama-Assn.Org. https://www.ama- assn.org/sites/ama-assn.org/files/corp/media- browser/public/ama-foundation/legal-operational-guide-free- medical-clinics.pdf Arends, R., Anderson Elverson, C., Pike Keefner, T., & Mylant, M. (2020). Screening, brief intervention, and referral to treatment training for family nurse practitioner students. Journal of the American Association of Nurse Practitioners,
  • 9. 33(5), 375–382. https://doi.org/10.1097/JXX.0000000000000423 Brom, H. M., Salsberry, P. J., & Graham, M. C. (2018). Leveraging health care reform to accelerate nurse practitioner full practice authority. Journal of the American Association of Nurse Practitioners, 30(3), 120–130. https://doi.org/10.1097/JXX.0000000000000023 Duquesne University. (2022, May 26). How to negotiate a nursing salary. Duquesne University School of Nursing. https://onlinenursing.duq.edu/blog/nurse- practitioner-contract-negotiation/ He, T. (2021, March 4). Medical mileage deduction: Everything you need to know. TripLog. https://triplogmileage.com/small- business/everything-you-need-to-know-about-the-medical- mileage-deduction/ Personal Support Worker HQ. (n.d.). Nurse practitioner salary in California explained (2022). Personalsupportworkerhq.Com. https://personalsupportworkerhq.com/california-nurse- practitioner-salary/ Salary.com. (2022). Nurse Practitioner salary in California City, CA. Salary.Com. https://www.salary.com/research/salary/benchmark/nurse- practitioner-salary/california-city-ca Weber, D. O. (2019). How Many Patients Can a Primary Care Physician
  • 10. Treat? Physicianleaders.Org. https://www.physicianleaders.org/news/how-many- patients-can-primary-care-physician-treat Appendix Nurse Practitioner Employment Contract EMPLOYER: JJC medical center TERMS OF EMPLOYMENT DURATION The contract duration is for one year with an option for renewal for five (5) years thereafter. COMPENSATION
  • 11. Salary: The contracted position will be paid at a salary rate of $105,000 per year. The contract will be renewed the sixth month after a review of the employee’s performance. Paychecks will be issued biweekly. Bonuses: The consideration of a bonus will be determined yearly based upon the assessment of the productivity, performance review, and financial status of the Corporation. There will be no guarantee of bonus payment, however, the Corporation maintains the philosophy that the value of an employee must be assessed, and the reward for the production of a job wel l done should be recognized with a financial reward. TERMINATION The termination of this contract may be made under the following conditions. Violation of State or Federal Law Breach of the Contract by either Party Performance of the NP Desire to Leave the Practice for Personal Reasons Financial Considerations of the Corporation In the event party desires to dissolve the agreement, they should provide the reason for the dissolution in writing to the other party with a minimum of 60 days’ notice. In the event an unreconcilable condition arises between the parties which cannot be resolved within this time frame, the parties may seek
  • 12. mediation to resolve the time parameter differences for the dissolution of the contract for employment. Immediate termination with cause may be made if there exist any legal or material impediments to the delivery of patient care by the NP which may include conditions that would potentially jeopardize the safety of the patients or place the corporation at unexpected financial or legal risk NON-COMPETE CLAUSE Because of the special skills and information regarding pain management which would be gained by the NP through employment, it is necessary to invoke a non-compete agreement. In the event of dissolution or termination of the contract, the following non-compete clause shall begin and remain in effect for two years. The NP shall not maintain or be employed in the Practice of Pain Management within a 50-mile radius of any of the corporation’s clinical practice locations. The NP may continue to practice in these areas; however, the total percentage of patients being seen for pain management in any subsequent practice of the NP will not exceed 10 (ten) percent. The NP shall not during the two-year period following termination of the contract with the corporation divert, coerce, or recruit patients involved in the medical practice of the corporation. For the two-year period after termination of the contractual agreement with the corporation, the NP will refrain from the treatment of all patients seen at the corporation either individually or collectively, unless otherwise agreed to by the corporation in writing. PERFORMANCE EVALUATION Annual performance evaluation of the NP shall be given for the purpose of improvement of the NP performance in the workplace. This evaluation shall include but is not limited to the review of 5% of the patient electronic medical records of the NP by the physicians of the practice for the following
  • 13. information: *Completeness *Accuracy *Accountability *Compliance with applicable State and Federal Guidelines regarding prescriptive issues The second component of the evaluation will include input from co-workers regarding interoffice communication, flexibility, and overall personability. The third component of the evaluation will include a self- assessment and the creation of an annual plan regarding professional goals for the upcoming year. ON-CALL RESPONSIBILITIES The corporation may request the availability of the NP when the Physician is out of town for the purpose of providing emergent patient assessment and referral. These On-Call scenarios should be planned with the NP. The mutual goal of maintaining 24 hours a day, 7 days a week patient care shall be considered the most important issue in the vigilance of consistent patient care. The physician shall be available for telephone consultation at all times to the NP in the event that the NP is on-call. The Physician will provide the NP with the information necessary to contact him during these time periods. The corporation defines the purpose of an On-Call NP as to provide emergent patient assessment and treatment only. The calling in of Prescriptive medication has been and will continue to be deferred to a scheduled appointment, noting it is the responsibility of the patient to maintain his/her medications at an appropriate quantity through planned scheduled appointments.
  • 14. ASSISTANCE: SECRETARIAL SUPPORT The corporation will staff the offices Monday through Friday, from 8:00 am to 4:30 p.m. The duties and responsibilities of the office personnel are to maintain patient assistance at check-in, telephone handling, patient scheduling, and the direction of patient flow through the clinic day. See the delineation of office duties in the job descriptions of the following: HOURS The hours of employment are as follows: Monday through Friday 8:00 am to 4:30 p.m. Saturday – hours to be arranged with mutual consent to accommodate the patient population and not paid at an additional rate. Saturday hours are only scheduled when it is deemed necessary by the President to accommodate the patient load and not as a regular event. Saturday hours will be no more than once per month and arranged with the consideration of the employee request given the request has been made is reasonable, reflecting the consideration of the office needs. The position will be paid at a salaried rate with the expectation that the hours worked reflect full- time employment and may require more than 40 hours. Those hours worked beyond a 40- hour workweek will not be paid at any additional rate, however, deference will be given to the NP in that overall the average workweek for the year will be 40 hours. HOLIDAYS Paid time off for all salaried employees includes the following days which are not computed as a vacation. 1. NEW YEAR’S DAY 2. MEMORIAL DAY
  • 15. 3. JULY 4 TH (Except when it occurs on a Saturday or Sunday then the holiday will be observed on either Friday or Monday) 4. LABOR DAY 5. THANKSGIVING DAY AND THE DAY AFTER 6. CHRISTMAS EVE 7. CHRISTMAS DAY 8. HALF A DAY- NEW YEAR’S EVE SICK LEAVE In the event of an acute illness, reasonable notice should be given to the employer. The primary practice physician should be contacted personally either at his home or by pager. Excessive calls concerning the use of unscheduled time off for repeated illnesses require the documentation of your Primary Care Physician. The allowable yearly maximum will be no more than 4 days. If the illness requires hospitalization, surgery, or other medical intervention requiring recovery time suggested by the Physician rendering the care he/she should convey these medical requirements to the primary practice physician in writing within one month of the planned medication intervention. More than 4 days of unscheduled time off for illness will result in the use of paid vacation days to be used for the occurrences. When the vacation days are exhausted then reduction of benefits and /or dismissal will be reviewed on an individual basis giving consideration of the circumstances and the demands of the practice. VACATION
  • 16. First-year of employment two weeks of vacation will be included in the salaried employee benefits plan. The salary will include the vacation benefit and no additional monetary benefit will be paid. In the third year of employment, the addition of the third week of vacation will accrue. In the fifth year of employment, the addition of the fourth week of vacation will accrue. Vacation time will be scheduled with a minimum notice of 6 weeks, the more notice given to the designee of the corporation will be greatly appreciated for the adjustment of patient and physician schedules. The vacation times request should be made in writing to the corporation and include the complete dates of your request including weekday and weekend dates. All reasonable requests will be considered, and approval of the requested vacation time will be made available to the employee within one week of submitting the written request. PERSONAL LEAVE Request for personal leave will be considered and vacation time will be used for the requested days off. Request for unpaid time off may be considered if there is no significant interruption in inpatient care and does not pose a significant burden to the daily operation of the corporation. CONTINUING EDUCATION The corporation is committed to the continuation of educational endeavors within the realm of Pain Management. The corporation will schedule educational seminars for the advancement of the employee in the practice. Should the employee desire to attend an educational offering unrelated to the practice of Pain Management sufficient course information should be submitted to the corporation for review and approval. The corporation will cover the cost inclusive transportation, lodging, and meals for Continuing Education for one week for
  • 17. the purpose of Continuing Medical Education. PROFESSIONAL MEMBERSHIPS Memberships to Professional organizations are not a condition of employment, however, it is expected certain key organizations and certifications should be achieved from time to time by the NP as evidence of both professional advancement and continuing education. The corporation will review memberships to such organizations and corporate funding will be allocated through an application process. Submit the required documentation for the requested organization including the nature of the membership and associated fees. LICENSES RENEWAL Current Indiana License is required prior to employment and will be verified by the Management. It is the responsibility of the employee to maintain his/her current Indiana License and submit a copy of the document prior to gainful employment. Failure to maintain this documentation as current will necessarily result in immediate cessation of salary and benefits until corrections are made. Payment for Health Professions Bureau fees will be issued to this agency by the corporation. PRESCRIPTIVE FEES All state and federally regulated prescriptive fees and documentation of DEA and state narcotic licenses are a condition of employment and must be submitted to the Management prior to employment for verification. Current copies of these documents shall be kept on file for immediate review at all times. Payment for Health Professions Bureau “Prescriptive Authority Advanced Practice Nurse” will be issued to this agency by the corporation. The following are included Prescriptive authority,
  • 18. controlled substances registration fees, and DEA licensure verification. COMMUNICATION Communication devices will be supplied by the Corporation and will remain property of said Corporation for the duration of employment. The devices provided shall not be used for personal communication and shall be returned to the employer upon departing from the Corporation. It is the responsibility of the employee to maintain the equipment in good condition and report any defects, problems, or malfunction. Repairs and replacement of the device will be the responsibility of the Corporation. TRANSPORTATION Transportation will be the responsibility of the employee. Transportation will only be provided when the employee is out of town for the purpose of attending a meeting, conference, and or education offering required by the Corporation. All receipts of the transportation will be required for reimbursement by the Corporation. Transportation should be arranged prior to the travel and an estimation of the cost and duration made at that time. When at all possible the Corporation will make these reservations and provide the information concerning the transportation prior to departure to the traveling parties. Transportation to the satellite offices will be the responsibility of the employee. Dependable transportation is an expectation for employment. INSURANCE Medical Insurance: The employee within the financial parameters defined by the Corporation may determine the type of plan selected. The plan
  • 19. identified by the employee should be submitted to the Corporation for review. The information to be submitted to the Corporation should include the type of plan, cost, and a contact person with the said insurance company. Malpractice Insurance: The employee will be carried on the primary physician’s Medical Malpractice Insurance for the duration of their employment. It is the option of the NP to purchase at their own expense, separate malpractice coverage. The Following Malpractice Insurance Company should be able to answer any question you may have concerning the policy. Upon employment, the Corporation will provide a copy of the updated edition of the employee’s coverage. PROFESSIONAL ISSUES The corporation will bill the Nurse Practitioner’s fees for the duration of the contractual agreement. It will be the responsibility of the employee to properly code the patient superbill on the electronic medical record computer software. Training on the system will be provided to the employee. Information Systems Security Agreement shall be signed between the employee and the Corporation. The corporation shall maintain sole ownership of any and all patient charts, mailing lists, and electronic – computerized information concerning patient data. The use of said information outside the practice shall be construed as a violation of the Patient’s HIPPA. rights and shall be prosecuted as such. Promotion of the Company: The employee shall represent the Corporation in a professional manner and as a representative of the company, the following methods of advertising may be employed for the continued
  • 20. promotion of our corporate philosophy. Newspaper Advertisements Business Cards Misc. other printed materials to promote the business for the general public. The inclusion of the employee’s name and credentials may be used in the promotion of the Corporation. The employee shall have the opportunity to review all material that contains his/her professional /personal identification. The employee written and/or verbal approval should be obtained in a reasonable time for the printing of the material. Objections or suggestions for the material will be given careful consideration prior to printing. Promotion of the corporation may require the attendance of various local and regional activities. The Nurse Practitioner may be asked to participate in the activity. The coordination of such events will be made with the approval and availability of the Nurse Practitioner. The NP should make an attempt to attend these functions given ample time and space in the schedule. Weekend events should be scheduled in advance and coordinated with the NP. Weekend promotional commitments are not mandatory and will not influence the practitioner’s employment status with the corporation. COOPERATIVE AGREEMENT The primary physician of the practice or any designated legal physician agent of the corporation will execute a cooperative agreement for the purpose of satisfying legal requirements for the continuing practice of the NP