AGREEMENT BETWEEN NEW HANOVER REGIONAL MEDICAL CENTER AND

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1 STATE OF NORTH CAROLINA COUNTY OF NEW HANOVER ALLIED HEALTH AFFlLIATION AGREEMENT AGREEMENT BETWEEN NEW HANOVER REGIONAL MEDICAL CENTER AND Fayetteville Technical Community College THIS AFFILIATION AGREEMENT (the "Agreement") is made effective this 16th day of May, 2012 (the "Effective Date"), by and between New Hanover Regional Medical Center ("Hospital"), and Fayetteville Technical Community College ("Educational Institution"), each a "Party" and collectively the "Parties". WIT NES S ETH WHEREAS, Hospital is a nonprofit corporation that operates an acute care hospital with two campuses located at 2131 South l7th Street, Wilmington, North Carolina ("NHRMC") and at 530 I Wrightsville Avenue, Wilmington, North Carolina ("Cape Fear Hospital") and operates other outpatient facilities either owned by the Hospital or any of its subsidiaries ("Facilities"). Hereinafter NHRMC, Cape Fear Hospital, and Facilities shall be referred to as Hospital unless otherwise specified); and WHEREAS, Educational Institution is an institution of higher learning and desires Hospital to serve as a site for Educational Institution students (the "Students) to rotate for a clinical and/or nonclinical educational experience; and WHEREAS, Hospital agrees to serve as such site in accordance with the terms and conditions of this Agreement. NOW THEREFORE, in consideration of the mutual promises in this Agreement, Hospital and Educational Institution agree as follows: Section I. GENERAL UNDERSTANDING: A. This Agreement shall apply to Educational Institution's Students and Educational Institution' s faculty members (the "Faculty") participating on site at the Hospital in a clinical and/or nonclinical educational experience in certain programs as set forth in Exhibit A (each a "Program"). During the term of this Agreement, Hospital and Educational Institution may mutually agree from time to time to revise Exhibit A, any such revisions shall be in writing and incorporated herein without further need for amendment. B. The Program will be of such content, and cover such periods of time as may from time to time be mutually agreed upon by the Parties. The starting and ending date for each Program shall be agreed upon at least one month before it commences. Implementation of each Program at the Hospital shall be subject to final approval by the Hospital. C. At least one month prior to the commencement of a Program, the Educational Institution 's designated Faculty and the Hospital's designated director or designee (the "Director") shall mutually determine the number of Students to rotate at Hospital (which may at any time be altered by mutual agreement) and the monthly, weekly and daily schedule for Students for each Program. D. All Students must be acceptable to both Parties and either Party may withdraw any Student from participating at Hospital based upon a lack of competency on the part of the Student, the

2 Student's failure to comply with the rules and policies of the Hospital (including but not limited to parking in areas not designated by Hospital as StudentlFaculty parking), or for any other reason where either Party reasonably believes that it is not in its best interest for the Student to continue. Such Party shall provide the other Party and the Student with immediate notice of the withdrawal and written reasons for the withdrawal. E. At least ten (10) days prior to the commencement of the Program, the Educational Institution shall provide the Director with the names of the Students scheduled to participate in the Program. The Hospital reserves the right to decline the acceptance of any Student from rotating at Hospital. F. Neither Party shall discriminate on the basis of race, national origin, religion, creed, sex, age, disability or veteran's status in either the selection of Students for participation in the Program, or as to any aspect of the Program; provided however, that with respect to disability, the disability must not be such as would, even with reasonable accommodation, in and of itself, preclude the Student's effective participation in the Program. G. It is expressly understood that the Students and Faculty shall not be considered Hospital employees, staff substitutes or authorized to act as agents on behalf of the Hospital. It is further understood that the Students are not entitled to any compensation from the Hospital in connection with the Program or the services rendered to Hospital clients and patients. Further, the Educational Institution does not expect compensation from the Hospital for such services, but desires to donate these services on an unconditional basis. Section II. RESPONSIBILITIES OF THE HOSPITAL A. The Hospital shall be responsible for the organization, administration, operations, and financing of its services. B. The Hospital shall retain responsibility for the care of its clients and patients and shall maintain supervision of the Students insofar as their presence and Program assignments affect the operation of the Hospital and its care, direct and indirect, of its clients and patients. No provision of this Agreement shall prevent any Hospital client or patient from requesting not to be a teaching client or patient or prevent the Director from designating any client or patient as a non-teaching client or patient. C. The Hospital shall be responsible for maintaining any and all standards required for accreditation by The Joint Commission (TJC). D. The Hospital shall allow the Students and Faculty to use available cafeteria facilities in the Hospital at their own expense. E. Hospital shall provide Educational Institution with information concerning the parking areas allowed for use by Students and Faculty. No other parking areas will be permitted. Student vehicles parked in non-studentlfaculty authorized areas may be towed at the owner's expense and may result in the Student being prohibited from continuing participation at the Hospital, at Hospital's sole discretion. F. The Hospital shall provide the Students and Faculty adequate use of, and access to, all necessary equipment, supplies and areas of the Hospital deemed by the Director to be necessary to carry out the objectives of the Program. Further, it shall be the duty of the Hospital, by and through the Page 2 of 10 Rev. Jan 2011 AH (Col/egelVniversily)

3 Director, to provide the requisite educational experiences in accordance with the educational objectives and schedule of the Program. G. The Hospital shall share the terms of this Agreement with appropriate Hospital staff and departmental supervisors, who shall upon request, assist the Director in the evaluation of the learning and performance of the Students. Any evaluation of Students by the Hospital or its staff shall relate only to general Student participation in the Program and shall in no way be construed as a certification by the Hospital as to the competence of any Student or a representation by the Hospital of any Student's ability or competence in connection with the practical implementation of any knowledge gained through the Program. H. The Hospital, by and through the Director, shall advise and direct Students in a clinical Program on the resolution of difficult patient issues in favor of the patient's welfare. During any such difficult patient issues, the Student's role shall be solely restricted to that of observer while Hospital representatives or Faculty resolve the issue according to the Director' s instruction. 1. The Hospital shall ensure that Student assignments are educational. J. The Hospital shall provide for the orientation of the Faculty and Students as to the philosophies, policies, procedures, rules and regulations of the Hospital, including all holidays observed. K. The Hospital hereby agrees to keep confidential any Student records or information it may obtain, unless it has otherwise obtained prior written consent of the Student. The Educational Institution shall obtain all required consents and the Hospital shall have the right to rely on such consents and to obtain copies of such consents upon request. Section III. RESPONSmILITIES OF THE EDUCATIONAL INSTITUTION A. The Educational Institution shall assume full responsibility for its Students and Faculty and shall utilize its best efforts to select Students for participation in the Program who have satisfactorily completed the prerequisite courses of their curriculum. The Educational Institution shall retain responsibility for the education of its Students. B. The Educational Institution shall collaborate with the Director in planning for observational and practical experiences pursuant to the Program's objectives. C. Prior to the commencement of the Program, the Educational Institution shall ensure: 1. Students and Faculty have a current, negative nine-panel urine drug test, a Yearly Influenza Vaccine (as described below), a yearly TB skin test or TB screening if a history of a positive TB skin test, proof of a Tetanus vaccine within the last ten years, proof of 2 Measles, Mumps, Rubella vaccines or titers, and a history of varicella (Chicken Pox) or proof of 2 varicella vaccines or titer. Hepatitis B vaccinations are recommended but not required. For all required vaccines listed above, exemptions may be considered based on documented medical contraindication from a physician or midlevel provider in writing or a bona fide and verifiable religious belief provided in writing to the Educational Institution and Hospital upon request. A copy of the drug test and vaccination record are to Page 3 of 10 Rev. Jan 2011 AH (ColiegelUniversily)

4 be made available to the Hospital upon request. Hospital reserves the right to conduct random and/or for cause drug tests, at Hospital expense, on Faculty and Students while participating on site. Yearly Influenza Vaccine: Required for all Students and Faculty participating in a Program during the flu season (generally October through March). Students and Faculty must receive the influenza vaccine prior to participation in the Program or within two weeks ofthe vaccine becoming available. 2. Students and Faculty members are apprised of their responsibilities, including but not limited to the following: Hospital; (a) To follow the administrative policies, standards and practices of the (b) regulations, and procedures; To report to the Hospital on time and to follow Hospital's rules, (c) To keep in confidence all medical, health, financial and social (including mental health) information pertaining to Hospital clients or patients; (d) To comply with all federal, state and local laws regarding the use, possession, manufacture or distribution of alcohol and controlled substances; (e) To follow Centers for Disease Control and Prevention ("CDC") Universal Precautions for Bloodborne Pathogens, CDC Guidelines for Tuberculosis Infection Control, and Occupational Safety and Health Administration ("OSHA") Respiratory Protection Standards; Hospital; (f) (g) To conform to established standards and practices while training at the To provide the necessary and appropriate uniforms; (h) To sign a written agreement obligating the Student or Faculty member to observe all rules and policies established by the Hospital and to maintain the confidentiality of patient information; (i) To recognize that all patient health information is the property of the hospital and this information may not be audio taped, photographed, videotaped, or photocopied or taken off the property without appropriate release by the Medical Records Department. U) To purchase an ID badge issued by the Hospital ("ill Badge"). The cost of an ID Badge, as well as any replacement cost in the event the ill Badge is lost or stolen, will be Fifteen Dollars ($15.00) which is subject to change from time to time at the sole discretion of the Hospital. Students and Faculty members must wear their ill Badge at all times while participating on site at the Hospital. 3. That professional liability insurance coverage is procured and maintained, or shall cause to be procured and maintained, for each Student and Faculty member participating on site at the Hospital in a clinical program, in amounts acceptable to the Hospital (minimum acceptable limits of coverage are One Million Dollars ($1,000,000) per claim, Three Million Dollars ($3,000,000) in the aggregate.) If such insurance is maintained on a claims-made basis, such insurance (or the procurement Page 4 of [0 Rev. Jan 2011 AH (CollegelUniversily)

5 of Extended Reporting Endorsement) shall continue for a minimum of four (4) years following the last day the insured partici pated at Hospital. Proof of such insurance shall be provided to the Hospital upon request. The Hospital recommends that the Students purchase and maintain adequate health insurance to cover the cost of any unanticipated medical expenses. below: 4. A criminal background check is conducted on all participating Students as provided (a) The criminal background check shall be at the expense of Educational Institution or that of the Student, and shall encompass both a state and federal criminal conviction report for the past seven years, including a social security match and maiden name match. Any Student's criminal background check that reveals a conviction of a felony shall be prohibited from participating at Hospital. Any Student's criminal background check that reveals a conviction of a misdemeanor or reveals pending charges shall be jointly reviewed by and jointly determined by the Educational Institution and the Hospital as to the eligibility of the Student for participating at Hospital. (b) Educational Institution shall provide the Hospital with written assurance that criminal background checks, as described in Section III. C. 4(a) above, have been conducted on all Students scheduled for participation at Hospital and said Students have no history that would warrant their exclusion or shall direct Students to provide a written authorization to release information obtained in said criminal background checks to the Hospital, and the Hospital will review. Students refusing to sign an authorization shall be prohibited from participating at Hospital. Institution shall: s. With regards to Faculty participating on site at the Hospital, Educational (a) Provide Hospital with written assurance that it has conducted a criminal background check to the satisfaction of the Hospital and such individual has no history that would warrant exclusion from participating at Hospital; and (b) Provide Hospital, in writing, with assurances upon initial placement and annually, or more frequently as Hospital may require, that Educational Institution has performed an employment evaluation of the said Faculty, and such individual meets or exceeds minimal employment and competency requirements. In the event a Faculty member is placed on suspension or has other performance actions, Education Institution shall remove such Faculty and provide a timely replacement with a qualified Faculty member. D. The Educational Institution shall have the fu ll responsibility for the conduct of any Student disciplinary proceedings and shall conduct the same in accordance with all applicable statutes, rules, regulations and case law. Section IV. MUTUAL RESPONSmILITIES A. The Parties will work together to maintain an environment of quality learning experiences for the Students, while at the same time enhancing the resources available to the Hospital for the provision of care to its clients and patients. At the request of either Party, a meeting or conference will be held to resolve any problems or develop any improvements in the operation of the Program. B. The Students will, at all times, work under the supervision of Faculty or Director; Page 5 of 10 Rev. Jan 2011 AH (Col/egelUniversily)

6 C. The Director and Faculty will cooperate in the concurrent and annual evaluation of the program; D. Faculty will assign Students with optimal learning experiences for which they have prepared. All educational assignments at the Hospital must be reviewed and approved by the Director; E. The Educational Institution shall maintain appropriate contact with the Hospital in order to fulfill the terms and conditions of this Agreement and in order to promote the communication necessary for the provision of appropriate academic preparation and educational experience. F. It is understood and agreed that detailed, written, signed operating procedures may be developed between the Educational Institution and the Hospital. In the event of conflict between such operating procedures and this Agreement, this Agreement shall control. G. If, following the execution of this Agreement, there should be any changes in any law, rule, or regulation of any State or Federal authority or agency, or interpretation thereof, which presents a question as to the legality, enforceability, or appropriateness of any provision of this Agreement, the Parties agree to promptly meet and amend or revise this Agreement as may be required to comply with any such applicable State or Federal law, rule, or regulation or interpretation thereof. In the event that the Parties are unable to agree on an appropriate amendment or revision within a period of thirty (30) days from the date that either Party gives notice to the other, this Agreement may be immediately terminated by either Party. H. Neither Party is an agent, employee or servant of the other. 1. The Educational Institution and the Hospital acknowledge that protection of Students and Faculty from exposure to bloodborne pathogens is a joint concern of all involved. The Hospital shall make available to Students and Faculty for use within the Hospital all personal protective equipment, including gloves, gowns, masks, and other supplies necessary to comply with CDC and OSHA guidelines. The Educational Institution shall provide Students and Faculty with education regarding bloodborne pathogens appropriate to the Student's educational experience at the Hospital, and, shall maintain documentation of such education. 1. Both Parties shall keep and maintain liability insurance coverage and worker's compensation insurance for itself and its employees issued upon such forms, containing such terms and limitations and in such amounts as are typically provided by facilities similar in size and location for each respectively (which may include self insured retention). If such insurance is maintained on a claim-made basis, such insurance shall continue throughout the term of this Agreement. K. To the extent allowed by law, each Party hereto (as the "Indemnifying Party") agrees to indemnify and hold harmless the other Party (as the "Indemnified Party") and its directors, officers, employees and agents from and against any losses, judgments, claims, costs, expenses (including reasonable attorney's fees), liabilities, or damages (collectively "Losses") asserted against the Indemnified Party by a third Party arising out of, or related to the acts or omissions of the Indemnifying Party, their officers, directors, agents, and employees. Page 6 of 10 Rev. Jan 2011 AH (CollegelUniversiry)

7 Section V. TERM AND TERMINATION A. This Agreement shall commence on the Effective Date and shall continue in effect for a period of one (1) year.. Thereafter, this Agreement shall automatically renew for successive one (I) year periods. Not withstanding the foregoing, either Party may terminate this Agreement at any time, without cause and without penalty, by providing the other Party written notice at least ninety (90) days prior to the intended date of termination. B. This Agreement may be terminated by either Party with cause upon ten (10) days written notice to the other Party; provided, however, that any Student currently participating in the Program at Hospital at the time notice of termination is given, whether with or without cause, shall be permitted to complete the Program in accordance with the terms of this Agreement. Section VI. AMENDMENTS This Agreement may be amended by mutual written consent of the Parties. Any amendment to this Agreement shall not take effect until in writing and signed by the Parties. Section VII. MISCELLANEOUS A. The construction and performance of this Agreement shall be controlled by the laws of the State of North Carolina. B. Neither Party may assign, delegate, or otherwise transfer any of its rights or obligations under this Agreement without the prior written consent of the other Party. C. This Agreement contains all of the terms agreed upon by the Parties with respect to the subject matter hereof and supersedes all prior agreements, arrangements, and communications between the Parties concerning such subject matter, oral or written, including but not limited to any prior agreement. D. Provisions of this Agreement shall be deemed severable, and the invalidity of any portion hereof shall not affect the validity of the remainder thereof. E. A waiver by either Party of any provision of this Agreement or breach of this Agreement shall not constitute a continuing waiver of such provision or a breach of any other provision or a subsequent breach. F. This Agreement is entered into for the sole benefit of Educational Institution and Hospital. Nothing contained herein or in the Parties' course of dealings shall be construed as conferring any third party beneficiary status on any person or entity not a Party of this Agreement, including, without limitation, any Educational Institution representative. G. Notice. Any notice required or desired to be given in respect to this Agreement shall be deemed to be given upon the earlier of (i) actual delivery to the intended recipient or its agent, or (ii) upon the third business day following deposit in the United States mail, postage prepaid, certified or registered mail, return receipt requested. Any such notice shall be delivered to the respective addresses set out below: Page 7 of 10 Rev. Jan 2011 AH (CollegeiUniversily)

8 If to NHRMC: New Hanover Regional Medical Center 2131 S. 17th Street Wilmington, NC Attn: Maureen A. Crossman Title: Facilitation Specialist If to Educational Institution: Fayetteville Technical Community College Physical Therapy Assistant Program PO Box Fayetteville, NC Dr. Heidi Shearin Department Chair [Signature Page Attached] Page 8 of 10 Rev. Jan 2011 AH (CollegelUniversity)

9 IN WITNESS WHEREOF, the authorized Parties hereto have set their hands below as evidence of their mutual agreement to the terms and conditions of this Agreement. NEW HANOVER REGIONAL MEDICAL CENTER By: Helen A. Coleman, Manager, Department of Education By: EDUCATIONAL INSTITUTION EDUCATIONAL INSTITUTION By: Page 9 of 10 Rev. Jan 2011 AH (ColiegelUniversity)

10 E:\lI lb l r i\ - ClIe 'k Bll x Di, is i(j 1l Sign:Jt lin' k~~ O- ~ ~=---- 3" I--'- "'=--= ~- (btl' , (, -_- j,.n 201 i.-i,lf i L :" /{: ~ : L, "V n n ~.'.\, t" j

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