If a health care facility leads patients into thinking that a service or provider is an agent of the health care facility, the facility is bound as if it is its own employee or service. The key factors in making this determination are:
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Does the health care facility control and supervise the treatment?
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Is the contracting individual subject to the health care facility's rules and regulations?
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Does the health care facility pay the person's salary directly?
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Does the hospital put its patients on notice that the person is an independent contractor?
The terms of external service contracts must be consistent with the policies of the health care facility and the liability coverage that protects the staff. The contract process should define the duties and objectives of the facility and the agency. Facilities should obtain a certificate of insurance, review all contracts periodically, and may wish to submit certain contracts to legal counsel for their review. If a contracted employee acts negligently, the health care facility could be held vicariously liable for damages. The contract must specify the party to be responsible for meeting the duties and obligations mandated by law. The delineation of responsibilities assists the health care facility in managing risk that it cannot avoid.