Resident Physician/Fellow Leave of Absence Policy 

I. Purpose. The purpose of this Resident Physician/Fellow Leave of Absence Policy (this “Policy”) is to  recognize the need to allow resident physicians/fellows to take reasonable leaves for qualified family and  medical reasons. The Policy is intended to summarize the benefits and eligibility requirements in order to  qualify. Residents may be required to extend their training to meet the mandated training  requirements of all agencies including but not limited to: ACGME, RRC and Relevant Specialty  Board even if granted leave under this policy.  

II. Scope. This Policy applies to all resident physicians/fellows employed by Kent Hospital (“Hospital”).  This Policy, which specifically applies to resident physicians/fellows, supersedes portions of Hospital’s  “Leave of Absence Policy 8371-0007” only with respect to resident physicians/fellows.  

III. Policy. Hospital will grant resident physicians/fellows leaves of absence (“LOA”) for the following  reasons: 

• For incapacity due to pregnancy, prenatal medical care or childbirth;  

• To care for the resident physician/fellow’s child after birth, or placement for either adoption or foster  care;  

• To care for the resident physician/fellow’s spouse, son or daughter, or parent, or mother in-law or  father in-law who has serious health condition; or 

• For a serious health condition that makes the resident physician/fellow unable to perform the resident  physician/fellow’s job; 

• Qualifying exigency leave for families of members of the National Guard and Reserves when the  covered military member is on active duty or called to active duty in support of a contingency  operation.  

(An employee whose spouse, son, daughter or parent either has been notified of an impending call or  order to active military duty or who is already on active duty may take up to 12 weeks of leave for  reasons related to or affected by the family member’s call-up to service. The qualifying exigency  must be one of the following: 1. short-notice deployment, 2. military events and activities, 3. child  care and school activities, 4. financial and legal arrangements, 5. counseling, 6. rest and recuperation,  7. post-deployment activities and 8. additional activities that arise out of active duty, provided that the  employer and employee agree, including agreement on timing and duration of the leave. The leave may commence as soon as the individual receives the call-up notice. Note: Son or daughter for this  type of leave is defined the same as for a child for other types of FMLA leave except that the person  does not have to be a minor. This type of leave would be counted toward the employee’s 13-week  maximum of FMLA/State leave in a 12- month period.  

• Military caregiver leave to care for an ill or injured service member;   

 (This leave may extend to up to 26 weeks in a single 12-month period for an employee to care for a  spouse, son, daughter, parent or next of kin covered service member with a serious illness or injury  incurred in the line of duty on active duty. Next of kin is defined as the closest blood relative of the  injured or recovering service member. Note: Former members of the Armed Forces and those on the permanent disability retired list are excluded.)  

This Policy is intended to encompass resident physicians/fellows’ leave entitlements under the federal  Family and Medical Leave Act (“FMLA”), the Rhode Island Parental and Family Medical Leave Act  (“RIPFMLA”), and applicable ACGME requirements regarding medical, parental, and caregiver  leave. Resident physicians/fellows who are entitled to leave under the FMLA, RIPFMLA, or  ACGME requirements will also qualify for a leave of absence under this Policy. Leave taken pursuant  to this Policy will run concurrently with leave under the FMLA, RIPFMLA, and ACGME  requirements, as applicable. 

In the event any questions arise as to the meaning or application of these policies, the following rules  shall apply: 

1. If the question involves FMLA and/or State Law rights of the resident physician/fellow or the employer, those laws will decide the issue and, 

2. All other issues will be resolved by the Hospital at its discretion. 

IV. Procedure. 

(a) Who is eligible for a LOA? All resident physicians/fellows, even in their first year, are eligible to  take a leave of absence, regardless of length of service or hours worked.  

Any impact of the LOA time on satisfying the completion of all educational requirements, as set  by the program’s respective accrediting body, must be reconciled prior to the resident  physician’s/fellow’s graduation. If necessary, the residency may be extended. 

(b) What Types of Serious Health Conditions Are Covered? This policy covers illnesses, injuries,  impairments, and physical and mental conditions that involve inpatient care or continuing treatment  or supervision by a health care provider. Generally, a chronic or long-term health condition that  would result in a period of five (5) consecutive days of incapacity with the first visit to a licensed  health care provider within 7 days of the onset of the incapacity and a second visit within 30 days  of the incapacity would be considered a serious health condition. For chronic conditions requiring  periodic health care visits for treatment, such visits must occur at least twice a year. 

(c) How Much Leave Can I Take and What Benefits are Granted to me While on Leave? Please  refer to the Hospital “Leave of Absence Policy Number (8371-0007)” for specific amounts of  allowable leave.

Pursuant to ACGME requirements, resident physicians/fellows are entitled to six (6) weeks of paid  leave at least once and at any time during their residency/fellowship, starting the day the  resident/fellow first reports. Therefore, the first six (6) weeks of a leave that a resident  physician/fellow takes under this Policy will be paid at 100 percent of the resident  physician/fellow’s salary. Thereafter, the leave will be unpaid. Resident physicians/fellows will  be required to use any available PTO concurrently with an unpaid leave under this Policy; provided,  however, that one (1) week of PTO will be reserved for the resident physician/fellow to use for any  purpose.  

Please remember that the number of weeks of leave to which the resident physician/fellow is  legally entitled includes all types of statutory leave. If the leave qualifies under both FMLA and  RIPFMLA, it will be counted towards the resident physician/fellow’s entitlement under both laws.  In order to make it easier to keep track of how much FMLA leave the resident physician/fellow has available, the Hospital will measure FMLA entitlements on a rolling 12-month basis. 

(d) What Fringe Benefits Will I Receive While on Leave? The Hospital will pay its share of the  premiums for the resident physician’s/fellow’s health insurance. The duration of such insurance  continuation is set forth on the leave table as provided in the Hospital “Leave of Absence Policy  (Number 8371-0007).” Pursuant to ACGME requirements, resident physicians/fellows are  guaranteed six (6) weeks of health and disability insurance benefit continuation for themselves and  their eligible dependents. During the period of leave, the resident physician/fellow must continue  to pay his/her share of the applicable premiums. 

When a LOA is approved, the resident physician/fellow will receive instructions on how to pay  his/her share of health insurance premiums. The Hospital reserves the right to deduct the resident  physician’s/fellow’s share of health insurance premiums from any pay that may be due to the  resident physician/fellow during or at the end of the leave. If the resident physician/fellow fails  to pay his/her share during the leave within thirty (30) days of the due date, the Hospital will  cancel the resident physician/fellow’s insurance after fifteen (15) days’ notice and after notifying the resident physician/fellow of the resident physician/fellow’s COBRA rights. Life and LTD are  continued where applicable. 

If the resident physician/fellow fails to return to work at the end of the resident physician/fellow’s leave, the resident physician/fellow will be liable to the Hospital for any health insurance  premiums paid by the Hospital on the resident physician/fellow’s behalf while on leave unless the  resident physician/fellow’s failure to return is due to the continuation, recurrence or onset of a  “serious health condition” or to circumstances beyond the resident physician/fellow’s control.  The Hospital may deduct amounts owed from any final paycheck and/or pursue other legal  remedies to collect these amounts. 

(e) What Are My Reinstatement Rights? Under FMLA, the resident physician/fellow is entitled to  reinstatement to the resident physician/fellow’s training position at the time of the resident  physician/fellow’s leave only. The resident physician/fellow’s reinstatement rights will be  determined by aggregating the amount of leave for all purposes (disability, family and parental) in  the preceding twelve (12) months. 

Failure to return to work at the end of the resident physician/fellow’s leave will result in  termination of the resident physician/fellow’s employment. Please refer to Graduate Medical  Education “Termination Policy KH-GME-003”

(f) How is “Intermittent Leave” and “Reduced Schedule” Leave Treated? FMLA permits  employees to take “intermittent leave” or “reduced schedule” leave, under certain circumstances,  because of the resident physician/fellow’s own or a family member’s serious illness. “Intermittent  Leave” would normally be used for doctor’s appointments or for periodic treatments (e.g., physical  therapy or chemotherapy). “Reduced schedule leave” is available only when the resident  physician/fellow’s physician so requires. A “Health Care Provider Certification” Form is required  for both of these types of leave. 

Leaves of this type will be counted (pro rata based on the resident physician/fellow’s regular schedule) towards statutory entitlements and are not available for birth, adoption or foster care. 

(g) Which Procedures are required to Qualify for Leave? The resident physician/fellow must request  a leave of absence for any period of absence that exceeds or will exceed five (5) scheduled days of  work. The resident physician/fellow’s request should be made to the resident physician/fellow’s immediate supervisor. 

If the need for the resident physician/fellow’s leave is foreseeable, the resident physician/fellow must make the request at least thirty (30) days before the leave is to begin. If thirty (30) days’  notice is not possible, the resident physician/fellow must make the request as soon as practicable,  within one or two workdays of the time the resident physician/fellow discovers the need for leave.  Prior to approval of any leave for the resident physician/fellow’s own serious health or for the  serious health condition of a family member, the resident physician/fellow must submit a  “Medical Certification Form” signed by a health care provider to the resident physician/fellow’s FMLA source. This certification must be submitted as soon as possible. A delay of more than  fifteen (15) days may result in denial of the resident physician/fellow’s leave. The Hospital  reserves the right, at the Hospital’s expense, to require certification from a provider of the  Hospital’s own choice and, in the event of a disagreement, to refer the matter to a third provider  for a final resolution. 

A “Healthcare Provider Certification” Form upon initiation of a leave and extensions must be  communicated to the resident physician/fellow’s supervisor. If the resident physician/fellow is on worker’s compensation, the resident physician/fellow must also give a copy of the note to  Occupational Health. 

Leaves related to serious health conditions will not be approved for periods longer than that  certified by the health care provider(s). In the event that a definite return date cannot be specified,  the leave will be approved only for a period ending one calendar week after the resident  physician/fellow’s next scheduled appointment with the provider. If the resident  physician/fellow’s approved leave exceeds thirty (30) days, the resident physician/fellow must  provide a medical recertification of the continued need for the leave every thirty (30) days. 

The resident physician/fellow’s supervisor will then notify the Human Resources Department by  completing a “Human Resources Personnel Action Form (951-44.01). 

The FMLA source will inform the resident physician/fellow in writing whether the resident  physician/fellow’s leave has been approved and will send the resident physician/fellow an  “FMLA Notice Form” explaining the nature of the resident physician/fellow’s leave and the  resident physician/fellow’s rights and obligations if the leave is approved. A COBRA notice, if  applicable, and application explaining the resident physician/fellow’s COBRA rights will be  provided to the resident physician/fellow by the Hospital’s third-party administrator.

Extensions. Requests for extensions of leaves should be made directly to the resident  physician/fellow’s immediate supervisor in addition to the resident physician/fellow’s FMLA  source, and must be made within one or two work days after the need for the extension is known  and, in any event, prior to expiration the resident physician/fellow’s approved leave. Where  warranted by exceptional circumstances, consideration will be given to extending benefits beyond  those delineated on a case by case basis. 

Failure to request a leave or an extension of a leave in a timely fashion may result in denial of the  leave and termination of employment. 

If the leave is due to the resident physician/fellow’s own serious health condition and is one week  or longer, the resident physician/fellow will also be required to furnish the Hospital with medical  certification of the resident physician/fellow’s fitness to return to work and to clear through  Occupational Health prior to returning to work. Care New England may additionally require a  fitness to return to work by an independent medical examiner. 

(h) How Are Worker’s Compensation Leaves Processed? If the resident physician/fellow suffers a  work related injury, the resident physician/fellow may qualify under the Hospital’s Worker’s  Compensation Program. These leaves are considered FMLA leaves and will be subject to the  provisions delineated in this policy. In addition, when the leave periods specified herein have been  exhausted, the resident physician/fellow will be placed in an “inactive” status from the end of the  leave entitlement period to twelve (12) months from the date of injury, in compliance with State  regulations. This inactive status is a non-benefit status. All benefits will be suspended while in this  status. At the end of twelve (12) months, if the resident physician/fellow is still unable to return to  work, the resident physician/fellow’s participation in the residency training program will be  terminated. 

(i) Mandatory Classes/Meetings/Training Session while on an LOA? Resident physicians/fellows  are not permitted to attend any department or hospital meetings while on active leave of absence.  Resident physicians/fellows on approved leaves of absences may, with approval from Human  Resources, attend classes and training programs provided by the hospital, but under no  circumstance will the resident physician/fellows be paid for such time. 

(j) Responsibilities 

Resident Physician: Submit “Request for Leave Forms” and request leave extensions to the  Residency Program Coordinator prior to going on leave, in writing if possible, and provide  medical certification at least every thirty (30) days. Continue to make health insurance  contributions. Make an appointment to clear through Occupational Health when ready to return  to work. Repay the Hospital the full cost of the resident physician/fellow’s health insurance if the  resident physician/fellow does not return to work following the the resident physician/fellow’s leave (unless disabled or no position is available). 

FMLA Source: Review and approve leave requests, forward approval to the resident physician, obtain signed FMLA notice from the resident physician and forward resident physician medical  information to Occupational Health for filing/retention. 

Occupational Health: Maintain employee medical files. Provide back to work clearances. Obtain  medical second opinions on some leave of absence.

Payroll: Obtain payment of full Hospital share of health insurance premiums from resident  physician who does not return from leave except as noted in this policy. Obtain resident  physicians/fellows portion of premium from resident physician while on leave where applicable. 

REFERENCES: 

Graduate Medical Education Policy Number: KH-GME-125 Due Process Policy 

Kent Hospital Human Resources Policy Number: 8371-0041 Termination Policy 

APPROVAL/REVISION: 

05/01/2015: Initial Version of Policy approved 

05/09/2017: Revision Approved 

04/12/2018: Revision Approved 

01/13/2019: Revision Approved 

04/15/2021: Revision Approved 

09/30/2022: Revision Approved (HR) 

05/09/2024: Reviewed – No Changes 

REPLACES: 

8034-002