Innovative Care Residency Agreement Essay

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Innovative Care
RESIDENCY AGREEMENT
August 1, 2013 RESIDENCY AGREEMENT TABLE OF CONTENTS
PAGE
I. Housing Accommodations and Services………………………………….
1
A. Housing Accommodations and Services………………………………
1
B. Basic Services………………………………………………………….
2
C. Additional Services…………………………………………………….
3
D. Licensure/Certification Status …………………………………..……..
4
II Disclosure Statement……………………………………………………….
4
III. Fees…………………………………………………………………………
4
A. Basic Rate……………………………………………………………….
4
B. Supplemental, Additional or Community, Fees…………………………
5
C. Rate or Fee Schedule…………………………………………………….
6
D. Billing and Payment Terms……………………………………………
6
E. Adjustments to Basic Services Rate or Additional or Supplemental Fees
6
F. Bed Reservation………………………………………………………….
7
IV. Refund/Return of Resident Monies and Property…………………………..
7
V. Transfer of Funds or Property to Operator………………………………….
8
VI. Property or items of value held in Innovative Care’s custody for You…………
8
VII. Fiduciary Responsibility…………………………………………………….
9
VIII. Tipping………………………………………………………………………
9
IX. Personal Allowance Accounts………………………………………………
9
X. Admission and Retention Criteria for an Assisted Living Residence………
10
XI. Rules of the Residence (if applicable)………………………………………
XII. Responsibilities of Resident, Resident’s Representative and Resident’s
11
Legal Representative………………………………………………………..
11
XIII. Termination and Discharge………………………………………………….
13
XIV. Transfer………..…………………………………………………………….
15
XV. Resident Rights and Responsibilities………………………………………..
16
XVI. Complaint Resolution……………………………………………………….
16
XVII.Miscellaneous Provisions………………………………..………………….
17
XVIII. Agreement Authorization…………………………………………………
18
i
TABLE OF EXHIBITS
EXHIBIT
SUBJECT
PAGE
I.A.1.
Identification of Apartment/Room ……………………………………..…
I
I.A.3.
Furnishings/Appliances Provided By Operator…………………………....
II
I.A.4.
Furnishings/Appliances Provided By You………………………………....
III
I.C.
Additional Services/Amenities Available …………………………………
IV
I.D. Licensure/Certification Status of Providers……………………………….
V
II
Disclosure Statement…………………………………………………….…
VI
III.A.2.
Tiered Fee Arrangements…………………………………………………..
XI
III B.
Supplemental, Additional or Community Fees…………………………….
XII
III.C.
Rate or Fee Schedule……………………………………………………….
XIII
V.
Transfer of Funds or Property to Operator…………………………………
XIV
VI.
Property/Items Held By Operator For You………………………………..
XV
XI.
Rules of the Residence…………………………………………………….
XVI
XV.
Residents Rights and Responsibilities…………………………………….
XVII
XVI.
Operator Procedures: Resident Grievances/Recommendations………….
XX
ii
RESIDENCY AGREEMENT
A. This agreement is made between ( _________________________ insert Operator’s Name ) the “Operator”, ______________________________________________ (the “Resident” or
“You”), ______________________________________________(the “Resident’s Representative”, if any) and ___________________________________________(the “Resident’s Legal Representative”, if any).
RECITALS
A. Innovative Care is licensed by the Nevada State Department of Health to operate at ___________________________________ (insert residence address as well as mailing address, if different) an Assisted Living Residence (“The Residence”) known as ____________________________________ ( insert Name of The Residence) and as an (select applicable category: Enriched Housing program and/or Adult Home). (Add if applicable and select applicable category) Innovative Care is also certified to operate, at this location, an Enhanced Assisted Living Residence, and/or Special Needs Assisted Living Residence.
B. You have requested to become a Resident at The Residence and Innovative Care has accepted your request.
AGREEMENTS
I. Housing Accommodations and Services.
Beginning on , , (Insert beginning date of residency)
Innovative Care shall provide the following housing accommodations and services
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