9 Contract Clauses You Should Read Closely

CRNA Contract Guide: Understanding Common Clauses 📘 CRNA Contract Guide: Understanding Arbitration & Independent Contractor Agreements A Deep Dive into the Fine Print That Shapes […]

September 2, 2025
CRNA Resources
7 min read
CRNA Contract Guide: Understanding Common Clauses

📘 CRNA Contract Guide: Understanding Arbitration & Independent Contractor Agreements

A Deep Dive into the Fine Print That Shapes Your Career

I put this guide together because, as CRNAs, we’re often asked to sign stacks of paperwork before an assignment starts — and let’s be real, most of us are focused on the clinical work, not the fine print. But hidden in those contracts are clauses that can shape your career, your paycheck, and your freedom to take future jobs. Some of these agreements are presented as if they’re “standard” or “required,” but when I pushed back, I learned that wasn’t always true.

This guide breaks down the most common clauses I’ve seen in real contracts — using actual language I was asked to sign — and explains what they really mean for you. My goal is to help you spot red flags, understand your rights, and move smarter in this market.

Arbitration Agreements

Picture This:

Twenty CRNAs discover the same underpayment pattern. Instead of one class case, each must pay to arbitrate separately, duplicating time and cost.

Clause Example:

“Provider and [the company] waive the right to have a court or jury trial on any arbitrable claim. … PROVIDER WAIVES THE RIGHT TO INITIATE, PARTICIPATE IN, OR RECOVER THROUGH, ANY CLASS OR COLLECTIVE ACTION.”

“Provider will be required to pay an initial [arbitration] filing fee … The arbitrator shall award the prevailing party its costs and reasonable attorney’s fees.”

Definition:

A private dispute process that replaces court. You give up the right to a jury and the right to bring or join class/collective action suits.

What It Means for CRNAs:

  • You must fight disputes one-on-one in private arbitration.
  • Outcomes are private and appeals are limited.
  • Fee-shifting can raise your risk exposure.
  • The arbitration may go through a company well-known to them and likely to favour them.

Red Flags

  • Broad class/collective action waiver.
  • “Prevailing party” attorney-fee language.
  • Clause that “survives” termination or the term of your agreement.

Protect Yourself

  • Ask if it’s required (it often isn’t).
  • Request each side bears its own legal fees.
  • If you accept, ask for worker-oriented rules and a local venue.

Independent Contractor Status

Picture This:

You injure your wrist and can’t take cases for six weeks. Because you’re not an employee, there’s no workers’ comp safety net unless you purchased separate coverage.

Clause Example:

“Provider is an independent contractor … Provider shall not be entitled to employee benefits, including health insurance, retirement, disability, or workers’ compensation.”

Definition:

Declares you are a 1099 contractor (not an employee). You handle your own taxes and benefits and lack employee protections.

What It Means for CRNAs:

  • No PTO, health plan, retirement match, unemployment, or workers’ comp by default.
  • Quarterly estimated tax payments are your responsibility.
  • More autonomy, but also more financial planning on you.

Red Flags

  • Wording suggesting employer-like control.
  • Silence on occupational accident/disability coverage.

Protect Yourself

  • Budget for taxes/benefits; set aside a percentage each check.
  • Consider an LLC/S‑corp and talk to a CPA.
  • Ask what insurance (if any) is provided for contractors.

Malpractice Insurance

Picture This:

A patient claim is filed for $1.5M. Because your personal policy was disclosed, it is tapped first; the agency’s policy responds only after your limits.

Clause Example:

“Provider shall disclose malpractice coverage obtained. [The company] may elect to provide malpractice insurance for Provider. Coverage shall be in amounts of $1,000,000 per occurrence and $3,000,000 aggregate.”

Definition:

Sets who’s covering malpractice and at what limits; your own policy may be considered before theirs if listed.

What It Means for CRNAs:

  • If you carry your own policy, theirs may be secondary.
  • Disclosing your policy can put your insurer first in line.

Red Flags

  • No statement making agency/facility policy primary.
  • Broad disclosure obligations for your policy details.

Protect Yourself

  • Ask for the agency's policy to be primary.
  • Provide proof of coverage (COI), not the full policy.
  • Confirm tail/limit responsibilities in writing.

Indemnification

Picture This:

A client alleges lost revenue due to staffing gaps on a shift you covered; the agency settles and then seeks reimbursement from you under the indemnity clause.

Clause Example:

“Provider shall indemnify and hold harmless [the company] from any losses, damages, or liabilities arising from Provider’s performance.”

Definition:

A promise to reimburse/protect the other party for losses tied to your work.

What It Means for CRNAs:

  • Could extend beyond malpractice into business losses or penalties.
  • May be triggered even when causes were outside your control.

Red Flags

  • Extremely broad terms like “any and all losses.”
  • One-way indemnity (you indemnify them; they don’t).

Protect Yourself

  • Limit to your negligence or willful misconduct.
  • Make it mutual (each party covers its own mistakes).
  • Ensure coverage aligns with malpractice limits.

Non-Compete / Non-Solicit

Picture This:

You complete a successful locums stint and receive a great permanent offer from that hospital. The clause prevents you from accepting for two years unless the agency is paid.

Clause Example:

“Provider agrees not to accept direct employment with [client] for two (2) years following introduction … unless [agency] receives a placement fee.”

Definition:

Restricts you from working directly with a client you met through the agency for a set period.

What It Means for CRNAs:

  • Can block a permanent offer at a site where you already proved fit.
  • May apply to affiliated entities, not just the exact facility.

Red Flags

  • Long durations (e.g., two years) and broad scope.
  • Application to entire health systems and affiliates.

Protect Yourself

  • Reduce to 6–12 months max.
  • Limit to the specific facility and role you covered.
  • Add exceptions for independent recruitment by the client.

Deductions from Pay

Picture This:

A facility changes your schedule last minute, you decline, and the agency deducts a “cancellation fee” from your next remittance.

“[The company] may deduct expenses or damages as set forth in the Agreement.”

Allows the agency to take money out of your pay for costs like cancellations, travel, or alleged damages, potentially without your direct consent for each instance.

Red Flags

  • Vague or open-ended deduction rights.
  • No requirement for your written consent.

Protect Yourself

  • Require your written pre-approval for any deductions.
  • Remove penalties except for proven misconduct.
  • Cap any allowable deductions.

Termination & Cancellation

Picture This:

You need to leave an assignment early for family reasons. The agency claims the hospital charged them, and they pass those costs to you as “damages.”

“Provider shall be responsible for damages if Provider fails to complete assignments.”

Defines how the relationship ends and what you may owe if you exit early, potentially including "lost profits" or other penalties charged to the agency.

Red Flags

  • Asymmetry (they can end immediately; you can't).
  • Damages defined to include profits/penalties.

Protect Yourself

  • Make notice periods mutual (e.g., 30 days).
  • Add a cure period (10–15 days) for fixable issues.
  • Limit damages to actual, direct costs only.

Survival Clauses

Picture This:

Months after finishing an assignment, a dispute arises and the agency invokes your continuing indemnity obligation.

“Certain provisions (including indemnification and confidentiality) shall survive termination.”

Lists which obligations continue after the agreement ends. You can remain on the hook for indemnity or other restrictions long after you've parted ways.

Red Flags

  • Survival of broad indemnity or restrictive covenants without time limits.

Protect Yourself

  • Limit survival to confidentiality and earned compensation.
  • Set reasonable time limits on any other surviving terms.

Closing Thoughts

At the end of the day, our signatures are powerful. Every time we pick up a pen or click “agree,” we’re deciding what protections we keep and what risks we accept. As CRNAs, we do some of the most high-stakes work in healthcare, and our contracts should respect that. Don’t let boilerplate language box you in or strip away your leverage. Read carefully, push back when you need to, and remember — we deserve agreements that reflect the value we bring to the head of the bed.

2 thoughts on “9 Contract Clauses You Should Read Closely”

  1. This review sheds light on some contracts that may appear harmless to casual observers but are actually filled with legal traps. It’s crucial to be aware of these important legal tips when signing a contract.

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