PHYSICIAN EMPLOYMENT CONTRACT CHECKLIST

Transcription

1 PHYSICIAN EMPLOYMENT CONTRACT CHECKLIST Alson R. Martin Shook, Hardy & Bacon LLP Mastin, Suite 1000 Overland Park, Kansas PHYSICIAN EMPLOYMENT CONTRACT CHECKLIST By Alson R. Martin Shook, Hardy & Bacon LLP Name of Employee & Employer TERM OF CONTRACT If other than on date of execution, specify starting date: If for set period of time, specify date of termination: Contingent Upon: License to Practice in (State) Eligibility for board certification in specialty Name specialty: Acceptance by corporation s malpractice carrier.

2 Acceptance on staff of Hospitals Execution and closing of Stock Purchase Agreement All hospitals serviced by Corp. OR Name hospitals Other Contingencies: Nullification Prior to Employment Automatic renewal (Use only if Term states end date; Renew unless written notice given days before expiration date). After becomes shareholder, contract identical w/other shareholders Option to extend days advance notice to extend for additional year w/same/different monthly salary; entitled to bonus for period thru. SALARY/COMPENSATION PROVISIONS Annual salary of $ (monthly installments). Monthly salary of $. Base Salary of $ per (mo/yr), plus additional comp as set forth in Shareholders Agreement Graduated salary: Dollar amount; or Percentage of salary paid to: highest paid employee; shareholder-employee; other:. Year 1: $ OR % of salary paid to type of employee shown above Year 2: $ OR % of salary paid to Year 3: $ OR % of salary paid to Year 4: $ OR % of salary paid to Compensation based upon Collections [ cash receipts or billings] less common, direct and indirect expenses. OPTIONS: Based upon a six-month average Capitation contract provision Allocation Of Capitation Payments. Option Compensation not to exceed that of name/s ; lowest full-time shareholder-employee, other (describe):. Salary/ Compensation (mark one) not to exceed average of shareholder-employees Compensation as determined in Shareholders Agreement All fees from prof. work are property of Corp. Payment of Compensation contingent on completion of dictation and paperwork.

3 EXPENSE ALLOCATION Common expenses (mark with c on list below) shared: equally among -employees; or proportionate to productivity other Indirect expenses (mark with i on list below) shared: proportionate to productivity other Direct expenses (mark with d on list below) - charged to employee individually: Indicate c, i or v on each applicable expense: accounting expenses advertising expenses automobile depreciation automobile expenses business entertainment casualty insurance collection expense communication expenses computer continuing education (travel, tuition, meals, lodging) disability insurance equipment equipment amortization equipment depreciation equipment/furniture rent furniture health insurance home and cellular phone interest expense key man insurance lab and x-ray supplies laundry expense legal expense liability insurance licenses & permits malpractice insurance marketing expense med reimbursement & other fringe benefits medical supplies membership in hospitals & insurance plans miscellaneous (bank charges, bottled water, medical waste) non-director staff recruitment non-shareholder retirement plan office rent outside lab & radiology services outside transcription services payroll taxes postage printing prof. business expense professional dues & fees property insurance repairs salaries of nonprofessional employees shareholder retirement plan staff dues, payroll taxes/fringe benefits subscriptions (& credit card fees) taxes (personal property, state franchise) supplies, office & administration workers comp. insurance other OPT: Corp. may reclassify expense categories. OPT: Common Expenses Only OPT: If Net collections is negative number, difference a debt by Employee to Corp.

4 Income Factors Net Collected Revenue from Ancillary Services by all employees (as defined in Stark II), allocated same as Physician-Encounters (office visits and surgery) including or not including, Capitation Revenue from Nurse Practitioner & Physician Assistant Revenue allocated to: Named -Employees: Equally to -Employees who utilize NP s and PA s from services by Non-Director Physicians allocated equally to -Employees OTHER EXPENSES Expenses of Nurse Practitioners and/or Physicians Assistants (comp, insurance, taxes, fringes, etc) allocated equally to [Names: ] and hereafter to any -Employee who utilizes them. OR to any -Employee who utilizes them. Working Capital-working capital, determined annually by Corp., pro-rated and subtracted from each -Employee s compensation equally proportionate to compensation BONUS PROVISIONS Discretionary bonus as determined by Corp Multi-Shareholder Discretionary amount set aside for bonus, as determined by Corporation, to be divided (indicate one of following OPTIONS). Bonus Divided: Equally among Shareholders Prorated for less than 12 months work. Proportionate to Salary Based on Productivity; collections (short form) Bonus & Salary Based on Productivity; fees collected prorated for less than 12 months work. Bonus based upon Productivity (Fixed salary not dependent on production) prorated for less than 12 months work. Advance bonus a debt? Yes No OPT: Right to inspect records re determination of bonus Bonus = % of Collections Attributable to Employee s Work Which Exceed $ OPT: Up to maximum of $ ; OPT: Plus % of collections exceeding $ INCLUDING retirement plan contributions; or REDUCED BY retirement plan contributions OPT: Employee also receives % of Corporation s Net Cash Receipts

5 Attributable to Employee s Work in excess of $ per year. INCLUDING retirement plan contributions; OR REDUCED BY retirement plan contributions OPT: Right to inspect records re determination of bonus Bonus Based on Total Collections of Corporation 1st yr: % of collections in excess of $ ; 2nd yr: % of coll. in excess of $. INCLUDING OR REDUCED by retirement plan contributions. OPT: Right to inspect records re determination of bonus Excess Bonus Payments (Advance Bonus a Debt to the Corporation if larger than Employee is entitled.) OPPORTUNITY TO BECOME SHAREHOLDER Contingent on renewal of emp contract; or new employment contact Other: STANDARD: If contract is continued beyond year(s), employee entitled to be considered to be equal shareholder. Other price to be agreed upon, payments over years with first payment due and last payment due ; Contingent upon revised or new contract, signing of shareholders agreement, agreement on fair market value of stock, & Corporation s determination appropriate to issue. OPT: Additional paragraph--accounts receivable not included in stock value; employee will reduce comp by (% or fraction) of collectible accounts receivable for years and Corporation will pay severance pay in accordance with Shareholders Agreement or other severance pay agreement. If contract is continued beyond year(s), employee entitled to be considered to become equal shareholder, with price determined by formula: 50% of accounts receivable + 50% of other assets (less debt & depreciation), calculated on 10 year straightline basis. Stock Purchase Opportunity after completing (yrs/mos) employment (no obligation by corporation or employee) OTHER SPECIFY EXACT TERMS: DUTIES Corporation hereby employs Employee to supply services in the field of (profession and specialty).