RESIDENT AGREEMENTagedcare.mercycs.org.au/files/file/application-documents/...Including the...

RESIDENT AGREEMENT

© 2015 James Underwood & Associates Pty Ltd

1 Jan 2015 Update

For Permanent Residents entering Approved

Residential Aged Care Services

DATED

(“The Provider”)

and

(“The Resident”)

RESIDENT AGREEMENT(“The Agreement”) Including the Accommodation Agreement

IMPORTANT NOTICE: Prospective Residents or their Representatives may ask for any assistance from the Provider to understand the information contained in this Agreement. Prospective Residents or their Representatives are also completely at liberty to, and are encouraged to, seek professional assistance to fully understand this Agreement. Advocacy Services, which can be accessed free of charge, are detailed in Attachment Three of this Agreement.

Prepared by:

T: 07 3229 8955 E: [email protected]

Reviewed by:

T : 07 3236 2900

E : [email protected]

Privacy Statement This organization respects and upholds individuals’ rights to privacy protection under the Australian Privacy Principles contained in the Privacy Amendment (Enhancing Privacy Protection) Act 2012. More information on our privacy policy is available from our office.

Disclaimer

James Underwood & Associates and CRH Law accept no responsibility for any loss as a result of any act or omission as a consequence of using this Agreement.

RESIDENT AGREEMENT

Jan 2015 © 2015 James Underwood & Associates Pty Ltd

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RESIDENT AGREEMENT


CONTENTS

RESIDENT AGREEMENT ............................................................................................................ 5

Recitals .............................................................................................................................................. 5

Main Details ...................................................................................................................................... 5

Operative Part ................................................................................................................................ 13

1. Residential Care Service .................................................................................................... 13

2. Calculation of Resident's Fees ........................................................................................... 13

3. Cooling off period ............................................................................................................... 15

4. Accommodation Payment & Accommodation Contribution ......................................... 15

5. Resident's Rights and Responsibilities ............................................................................. 16

6. Leave From Care Facility .................................................................................................. 17

7. Default ................................................................................................................................. 18

8. Termination Generally ...................................................................................................... 18

9. Termination by the Resident ............................................................................................. 19

10. Security of Tenure .............................................................................................................. 19

11. Resident’s Rights Upon Being Asked to Leave the Care Facility .................................. 20

12. Notices ................................................................................................................................. 20

13. Costs and Stamp Duty ....................................................................................................... 21

14. Rules of Residency .............................................................................................................. 21

15. Privacy ................................................................................................................................. 21

16. Variation ............................................................................................................................. 21

17. Complaint Resolution ........................................................................................................ 22

18. Resident’s Representative ................................................................................................. 22

19. Enduring Power of Attorney ............................................................................................. 22

RESIDENT AGREEMENT


20. Legal and Financial Advice and Assistance to Understand Agreement ....................... 23

21. Extra Services ..................................................................................................................... 23

22. General ................................................................................................................................ 24

23. Special Conditions .............................................................................................................. 24

24. Unfunded Places ................................................................................................................. 24

25. Definitions of Words Used and Interpretation ................................................................ 25

Schedule 1 – Specified Care and Services for Residential Care Services ................................. 31

Schedule 2 – Charter of Care Recipients’ (Residents’) Rights and Responsibilities ............... 44

Schedule 3 – Rules of Residency ................................................................................................... 48

Schedule 4 – Accommodation Payment & Accommodation Contribution .............................. 49

Schedule 5 – Extra Services - List of Accommodation, Food & Services ................................. 61

Schedule 6 – Extra Service Fee ..................................................................................................... 64

Schedule 7 – Special Conditions ................................................................................................... 65

Attachment One – Moves Within the Care Facility .................................................................... 66

Attachment Two – Aged Care Complaints Scheme .................................................................... 68

Attachment Three – Advocacy Services ....................................................................................... 69

Attachment Four - Declarations ................................................................................................... 71

RESIDENT AGREEMENT


RESIDENT AGREEMENT THIS AGREEMENT is made on the date set out in Item 1 of the Main Details BETWEEN: ____________________________________________________________________ ("the Provider") AND: ___________________________________________________________________ ("the Resident") RECITALS

A. The Provider operates the Care Facility. B. The Resident wishes to be provided with Residential Care and Accommodation at the Care

Facility. C. The Provider agrees to provide the Resident with Care and Accommodation as set out in this

Agreement which incorporates the Pre-Admission Agreement with the Resident in its entirety. NOTE: See Dictionary and Interpretation in clause 25 for definitions of terms used in this Agreement.

MAIN DETAILS

FUNDING

The Place being offered to the Resident is a “Funded Place an “Unfunded Place”

If the offered Place is an “unfunded place”, please see Clause 24 in this Agreement for important information.

ITEM 1. DATE OF AGREEMENT: The day of 20 2. PROVIDER:

Name Address Telephone Fax Email

3. RESIDENT:

Name Address Telephone Email

RESIDENT AGREEMENT


4. RESIDENT’S REPRESENTATIVE: Name Address Telephone Email

5. RESIDENT’S ENDURING POWER OF ATTORNEY / AUTHORISED GUARDIAN: Name Address Telephone Email

6. CARE FACILITY: Name Address Telephone Fax Email Approval No.

7. DATE OF START OF PRE-ENTRY LEAVE:

Note: Basic Daily Fees and Means Tested Care Fees commence from the start of any Pre-entry Leave period. The Start of Pre-entry Leave, if any, is shown in this Item. Accommodation Payments commence from the Date of Entry.

8. DATE OF ENTRY:

Note: This is the date on which a new Resident physically enters the Care Facility and may be up to seven days after the Start of Pre-entry Leave.

9. INITIAL DAILY RESIDENT FEES

Basic Daily Fee (BDF) $

Plus

Means Tested Care Fee (MTCF) or Interim MTCF

Compensation Payment Adjustment

Daily Payment at Entry

Daily Contribution at Entry or Interim Daily Contribution

“Unfunded Places” Fee or Other Agreed Amount

Extra Service Fee

Total $

Less

Hardship Supplement

Any Permanent Rebate or Fee Reduction

Total Initial Daily Resident Fees $ Notes:

a) The Resident shall complete an Authority for a Direct Debit facility for payment of all fees and charges to the Provider.

b) These are initial fees only. All fees & charges may be subject to CPI and/or other increases or changes, as specified in this Agreement.

c) Where an Extra Services Fee is specified in Item 9, this identifies that an Extra Services place has been offered and accepted. Please see Clause 21 for details.

RESIDENT AGREEMENT


d) In addition to the Initial Daily Resident Fees shown in Item 9, a MTCF or a Daily Contribution (if applicable) will not usually have been calculated as at Date of Entry to the Care Facility. The MTCF or Daily Contribution is normally determined by the Department after a Resident’s admission. The MTCF or Daily Contribution is nonetheless effective from Date of Entry as a permanent Resident where no Pre-entry Leave is used, otherwise from the Start of Pre-entry Leave.

If the Department has not yet advised the Resident and the Provider of the MTCF or Daily Contribution at the Date of Entry or the Start of Pre-entry Leave, an interim amount may be charged to the Resident until the final figure is known, at which time the Provider will reconcile the fees charged and detail an adjusting balance, as appropriate.

10. INTEREST RATE: % p.a.

(Applicable to Daily Payments calculated on any outstanding Accommodation Payment and to any other outstanding fees and charges)

________________________________________________________________________________________________ ACCOMMODATION PAYMENTS / ACCOMMODATION CONTRIBUTIONS

The Resident is required to pay an Accommodation Payment. Please go to Item 11, below.

The Resident has an advice from DHS or DVA that they are a Low-means Resident who is assessed as being able to pay an Accommodation Contribution, Please go to Item 17 (Page 9).

The Resident has an advice from DHS or DVA that they are a Low-means Resident who is assessed as being able to pay no Accommodation Contribution. Please go to the signatory page (Page 11)

ITEMS 11 TO 16 ONLY APPLY TO RESIDENTS PAYING AN ACCOMMODATION PAYMENT 11. ACCOMMODATION PAYMENT

The Accommodation Payment for the agreed Room is $

The Resident may elect to pay the Accommodation Payment (i) in one Refundable Deposit (RAD); (ii) wholly by Daily Payments (DAPs); or (iii) by a combination of Refundable Deposit (RAD) and Daily Payments (DAPs).

The Resident has elected to pay the Accommodation Payment from the Date of Entry

(Insert one of the elections) In accordance with the Resident’s Election, detailed at Item 11, above, please complete just one of the following Items 12, 13 or 14:

12. REFUNDABLE DEPOSIT (RAD) ONLY 12.1. The total Refundable Deposit is $

12.2. The Refundable Deposit is due on or before

NOTE: The Refundable Deposit is payable within six months of the Date of Entry. 12.3. A Daily Payment is payable on any unpaid portion of the Accommodation Payment from the

Date of Entry but if the Refundable Deposit is paid in full within days of the Date of Entry, the Daily Payment will be waived. The Daily Payment also remains payable on any outstanding Refundable Deposit amount if the Refundable Deposit is not paid by six (6) months after the Date of Entry.

RESIDENT AGREEMENT


12.4. (Partial Payment) The Resident has agreed to pay an amount of $ as at Date of Entry or by as partial payment of the agreed Refundable Deposit. This reduces the amount of Daily Payment which would otherwise be payable and the Resident may elect to have any Daily Payments withdrawn from this partial Refundable Deposit.

12.5. Once the Partial Payment of $ is paid, the Daily Payment will be $ /day and is shown in Item 9 of the Main Details.

OR 13. DAILY PAYMENTS (DAPs) ONLY 13.1. The total Accommodation Payment is $ and is to be paid as a Daily Payment.

13.2. The due date for commencement of Daily Payments is (i.e.The Date of Entry).

13.3. The Daily Payment is $ /day and is shown in Item 9 of the Main Details.

OR 14. COMBINATION OF REFUNDABLE DEPOSIT (RAD) & DAILY PAYMENTS (DAPs)

General

14.1. The total Accommodation Payment is $ and is to be paid as a combination of a Refundable Deposit and Daily Payments.

14.2. The amount to be paid as a Refundable Deposit is $

14.3. After the agreed Refundable Deposit is paid, the outstanding Accommodation Payment amount on which the ongoing Daily Payment will be determined is $

Refundable Deposit

14.4. The due date for payment of the agreed Refundable Deposit is (i.e. Six months after the Date of Entry).

14.5. A Daily Payment is payable on any unpaid portion of the agreed Refundable Deposit from

Date of Entry whilst that portion of agreed Refundable Deposit remains outstanding.

14.6. A Daily Payment also remains payable on the outstanding Refundable Deposit amount if it is not paid by six (6) months after the Date of Entry.

14.7. (Partial Payment) The Resident has agreed to pay an amount of $ as at Date of

Entry or by as partial payment of the agreed Refundable Deposit. This reduces the amount of Daily Payment which would otherwise be payable and the Resident may elect to have any Daily Payments withdrawn from this partial Refundable Deposit.

Daily Payments

14.8. The due date for commencement of Daily Payments is (i.e. The Date of Entry).

14.9. The Daily Payment is based on the amount of Accommodation Payment that is outstanding at any time, including any unpaid agreed Refundable Deposit.

14.10. Once the agreed Refundable Deposit of $ is paid, the Daily Payment will be $ /day.

RESIDENT AGREEMENT


15. DAILY PAYMENTS WITHDRAWN FROM THE REFUNDABLE DEPOSIT At the Resident's request, any amount of the Daily Payments can be deducted from the Refundable Deposit. Any such agreement is detailed below:

15.1. An amount of $ /day of Daily Payments as at Date of Entry is agreed to be withdrawn from the Refundable Deposit lump sum balance in lieu of being paid directly by the Resident as a regular Daily Payment.

16. RESIDENT FEES WITHDRAWN FROM THE REFUNDABLE DEPOSIT

16.1. An amount of $ /day or $ /fortnight or $ /month of Resident Fees other

than Daily Payments or Daily Contributions is agreed by the Provider to be withdrawn from the Refundable Deposit lump sum balance in lieu of being paid by the Resident as part or all of Daily Resident Fees.

ITEMS 17 TO 21 ONLY APPLY TO RESIDENTS PAYING AN ACCOMMODATION CONTRIBUTION Note: The amount of Accommodation Contribution may not yet have been determined by DHS/DVA and advised to the Resident by Date of Entry. In these cases, an Interim Accommodation Contribution can be specified by the Provider. 17. ACCOMMODATION CONTRIBUTION (FOR LOW-MEANS RESIDENTS ONLY)

The Resident may elect to pay the Accommodation Contribution

(i) wholly by Daily Contributions (DAC); or (ii) in one Refundable Contribution (RAC) (this option is not available at current interest

rates); or (iii) by a combination of Refundable Contribution (RAC) and Daily Contributions (DAC). The Resident has elected to pay the Accommodation Contribution from the Date of Entry

(Insert one of the elections) In accordance with the Resident’s Election, detailed at Clause 17, above, please complete just one of the following Items 18, 19 or 20:

18. DAILY CONTRIBUTIONS (DACs) ONLY 18.1. The Daily Contribution is $ /day and is shown in Item 9 of the Main Details.

18.2. The due date for commencement of Daily Contribution is (i.e. The Date of Entry).

18.3. The Daily Contribution is the amount advised by the Department effective from Date of Entry

OR

19. REFUNDABLE CONTRIBUTION (RAC) ONLY – this option is not available at current Interest Rates

19.1. If the Resident elects to pay the Accommodation Contribution in one lump sum, called the

Refundable Contribution, the whole of the Refundable Contribution must be paid no later than six (6) months from the Date of Entry. The Daily Contribution is payable in full from the Date of Entry until the total Refundable Contribution is paid.

RESIDENT AGREEMENT


19.2. The total Refundable Contribution is $

19.3. The due date for payment of the Refundable Contribution is

(i.e. Six months after the Date of Entry).

19.4. The Daily Contribution remains payable if the Refundable Contribution is not paid by six (6) months after the Date of Entry.

OR

20. COMBINATION OF REFUNDABLE CONTRIBUTION (RAC) & DAILY CONTRIBUTIONS (DACs)

20.1. If the Resident elects to pay the Accommodation Contribution partly by Refundable Contribution and partly by Daily Contributions, the agreed Refundable Contribution amount must be paid on or before six (6) months from the Date of Entry. In addition, Daily Contributions are to be paid from the Date of Entry. The agreed combination as at Date of Entry is detailed in this item.

General

20.2. The total Accommodation Contribution is calculated by the Department and expressed as a Daily Contribution. The total Accommodation Contribution is $ . If the Resident elects to pay a combination of Refundable Contribution and Daily Contribution, then the total Accommodation Contribution is the sum of any paid Refundable Contribution, expressed as a Daily Contribution, plus any outstanding Accommodation Contribution amount, expressed as a Daily Contribution.

Refundable Contribution 20.3. The amount to be paid as a Refundable Contribution is $

20.4. The due date for payment of the agreed Refundable Contribution is (ie. Six months after the Date of Entry).

20.5. The full Daily Contribution advised by the Department is payable from Date of Entry whilst the agreed Refundable Contribution remains outstanding.

20.6. The full Daily Contribution remains payable if the Refundable Contribution is not paid by six (6) months after the Date of Entry.

Daily Contributions 20.7. The due date for commencement of Daily Contribution is (i.e. The Date of Entry).

20.8. Once the agreed Refundable Contribution is paid, the Daily Contribution will be $ /day

20.9. The full Accommodation Contribution advised by the Department as a Daily Contribution of

$ /day is payable whilst the agreed Refundable Contribution remains outstanding.

21. DAILY CONTRIBUTIONS WITHDRAWN FROM THE REFUNDABLE CONTRIBUTION

21.1. At the Resident's request, any amount of the Daily Contributions can be deducted from the

Refundable Contribution. An amount of $ /day of Daily Contributions as at Date of Entry is agreed to be withdrawn from the Refundable Contribution balance in lieu of being paid directly by the Resident as a regular Daily Contribution.

RESIDENT AGREEMENT


This Agreement includes the Pre-Admission Agreement, Main Details, the Operative Part and all Schedules and Attachments. SIGNED by (The Provider) ) ) ) ( Signature for the Provider)

In the presence of:

Name of Person Signing for the Provider (Print)

Signature of Witness

Name of Witness (Print) Date :

SIGNED by (The Resident) ) ) In the presence of: ) (Signature of person signing as The Resident)

Designation: Resident Enduring Power of Attorney Other, please specify _____________________


Name of Person Signing as the Resident (Print)


SIGNED by (The Resident’s Representative) ) ) ) (Signature of the Resident’s Representative)

In the presence of:

Name of Resident’s Representative (Print)



RESIDENT AGREEMENT



RESIDENT AGREEMENT


OPERATIVE PART

This Agreement includes the Main Details and all schedules and attachments. The Parties agree that: 1. RESIDENTIAL CARE SERVICE

1.1. The Provider agrees to provide to the Resident, Accommodation and Residential Care and services that the Resident is assessed as requiring as at the date of this Agreement.

1.2. The Provider will continue to provide Accommodation and Residential Care and services to

the Resident during the period commencing on and from the Date of Entry, where no Pre-entry Leave is used, otherwise on and from the Start of Pre-entry Leave, for the lifetime of the Resident or such earlier date if this Agreement is terminated in accordance with its terms.

1.3. The Provider will work towards assisting the Resident to remain in the original room they entered upon admission to the facility as a permanent Resident (called "Ageing in Place"). However, the Resident's assessed long-term care needs may necessitate future moves to different rooms in more appropriate areas of the Care facility in order to best meet the needs of the Resident and also the needs of other Residents. The Provider will only undertake any move in accordance with the Security of Tenure conditions detailed in Clause 10 of this Agreement

1.4. The Resident's rights under this Agreement are personal to the Resident and they may not be transferred.

1.5. Nothing in this Agreement shall create any lease or tenancy in the Resident's favour nor shall the relationship of landlord and tenant exist between the Provider and the Resident.

1.6. The Resident will have the right, together with other Residents and authorised persons, to share the use and enjoyment of the communal areas, facilities and amenities of the Care Facility from time to time set aside by the Provider except to the extent that the Provider restricts use of those communal areas, facilities and amenities.

1.7. For the purposes of the Act this Agreement is entered into:

(a) as a Resident Agreement; and

(b) if an Accommodation Payment is payable, as an Accommodation Agreement; and

(c) where the Care Facility has Extra Service Status or where the Accommodation is provided in a distinct part of the Care Facility having Extra Service Status - as an Extra Service Agreement.

2. CALCULATION OF RESIDENT'S FEES

2.1 The provisions of this clause 2, clause 4, clause 6 and clause 21 set out the policies and practices that the Provider will follow in setting the Resident Fees.

2.2 The Resident must pay by way of Resident Fees to the Provider the Maximum Daily Amount of Resident Fees worked out in accordance with the Act, as follows:

(a) the Basic Daily Fee for the Resident, plus (b) the Compensation Payment Adjustment (if any), plus

RESIDENT AGREEMENT


(c) the daily Means Tested Care Fee (if any), less (d) the amount of any Hardship Supplement , plus (e) the sum of any other amounts agreed upon between the Resident and the Provider ,

plus (f) where it has been agreed to provide services to the Resident on an Extra Services basis,

the amount of the Extra Service Fee (if any) that is specified in Item 9 in the Main Details.

2.3 Resident Fees are payable fortnightly or monthly (as specified by the Provider) in advance by

the Resident and, where monthly, will be calculated by multiplying the number of days in a month by the maximum daily amount of resident fees from time to time PROVIDED THAT the resident will not be required to pay Resident Fees for any period prior to the Date of Entry other than for a period starting on the later of:

(a) the day on which the Resident was notified that there was a vacancy in the Care

Facility; or (b) the day that is seven days, or such other period as is mentioned in the Subsidy

Principles, before the Date of Entry and ending on the Date of Entry. 2.4 Subject to the provisions of clauses 2.8 and 2.9, the Resident Fees payable by the Resident on

the Date of Entry have been worked out on the basis of information available to the Provider and are, subject to recalculation, the daily amount described as Initial Daily Resident Fees as set out in Item 9 of the Main Details.

2.5 Subject to the provisions of clause 2.7, Resident Fees will be payable during the Resident's occupancy (including any periods of leave as assessed under the Act) and will continue to be payable until the Resident has vacated the Care Facility together with all belongings.

2.6 The Basic Daily Fee is determined by the Department and is subject to change.

2.7 If the Resident is absent from the Care Facility for any reason other than continuous hospital leave of 29 days or more to the extent that any of the amounts otherwise payable to the Provider by the Department (including but not limited to the Residential Care Subsidy) ("Department subsidies") in respect of the Resident ceases, the Resident will pay to the Provider, in addition to the Resident Fees otherwise payable by the Resident to the Provider, an amount equal to the Department subsidies that would have been payable to the Provider had the Resident not been absent from the Care Facility.

2.8 If the Provider does not have all of the information required to work out the Resident Fees on the Date of Entry, the Resident acknowledges that the Provider may work out the Resident Fees payable by the Resident on the basis of the information which the Provider has received.

2.9 Where the DHS or DVA has made a determination that Resident Fees should have been more than the amount charged by the Provider to the Resident, the Resident will pay to the Provider the amount of the underpayment within one (1) month of the determination or, if there has been an overpayment of Resident Fees properly payable by the Resident the Provider will reduce the amount payable by the Resident for the month following the determination to the extent of any such overpayment.

2.10 If the amount of Resident Fees paid by the Resident to the Provider is higher than the amount of Resident Fees that was properly payable, the Provider will refund to the Resident the difference between the amount of Resident Fees that was properly payable and the amount of

RESIDENT AGREEMENT


Resident Fees that was paid in the next monthly account for the Resident after the overpayment was identified.

2.11 If the Provider provides to the Resident services, equipment, aids, or medications, or other goods that are required specifically for the Resident and are not included in the fees in Schedule 1 or Schedule 5 (whichever is applicable), the Resident will be responsible for the cost of those items as payments additional to the Resident Fees under clause 2.2 (e).

2.12 If information provided by the Resident or the Resident's Representative or any person on his or her behalf which is used by the Provider to determine the Resident Fees payable under this Agreement proves inaccurate, the Resident must reimburse the Provider for any loss of income relating to the Provider's reliance upon the inaccuracy and the Resident acknowledges that the Provider may recalculate the Resident Fees utilising the correct information.

2.13 If from time to time there shall occur any changes in the law that require or permit the Resident Fees to be worked out and charged in a manner different from the manner in which the Resident Fees payable by the Resident under this Agreement are calculated, the Provider shall have the right to vary the manner in which the Resident Fees are worked out accordingly so that the Resident will at all times pay to the Provider not less than the Maximum Daily Amount of Resident Fees worked out in accordance with the provisions of the Act and this Agreement.

2.14 If the Resident dies or departs from the Care Facility any Resident Fees paid in advance must be refunded in accordance with the Fees and Payments Principles.

2.15 Clause 6 sets out the calculation of Resident Fees relating to periods while the Resident is temporarily absent from the Care Facility.

3. COOLING OFF PERIOD

3.1 The Resident may at any time within 14 days from the date of signing this Agreement advise the Provider in writing that the Resident wishes to withdraw from this Agreement.

3.2 Where the Provider receives a notice from the Resident or the Resident's Representative under

clause 3.1:

(a) this Agreement will become void and;

(b) the Resident will be liable for the Resident Fees payable for any period when the Resident was in the Care Facility (this will include any Resident Fees and other charges incurred in respect of the Resident's period of occupancy under this Agreement); and

(c) the Provider will refund any other amount paid by the Resident under this Agreement.

4. ACCOMMODATION PAYMENT & ACCOMMODATION CONTRIBUTION

4.1 The Resident will pay the Accommodation Payment if:

(a) The Resident's Means Tested Amount at the Date of Entry is equal to, or greater than, the maximum Accommodation Supplement amount for that day; or

(b) The Resident does not provide sufficient information to allow the Resident's Means Tested Amount to be worked out.

RESIDENT AGREEMENT


4.2 If the Resident's Means Tested Amount at the Date of Entry is less than the maximum Accommodation Supplement amount for that day, the Resident will be required to pay an Accommodation Contribution, depending on the Resident's Means Tested Amount, as set by the Department.

4.3 Any determination that the Resident has Low-means Resident Status has been calculated in

accordance with the provisions of the Act based upon the information the Resident or the Resident’s Representative has provided to the Provider in relation to the assets and income of the Resident as at the date of the Agreement (including without limitation the information attached as Attachment Four). If the information so provided is inaccurate or revised by a DHS or DVA means assessment and the Resident is determined to not be eligible for Low-means Resident status, (in addition to all and any other rights the Provider may have as a consequence) the Provider will calculate the Accommodation Payment applicable to the agreed Room and the Resident will be subject to paying that Accommodation Payment from Date of Entry.

4.4 In addition to payment of the Resident Fees and the other charges payable under this Agreement, the Resident must pay the Accommodation Payment or Accommodation Contribution (if any) calculated and payable in accordance with the provisions of Schedule 4.

4.5 Arrangements for a varied Accommodation Payment on moving within the Care Facility are detailed at Attachment One to this Agreement

4.6 The Provider is entitled to any income which it earns from the amount(s) paid by the Resident in respect of the Refundable Deposit or Refundable Contribution.

5. RESIDENT'S RIGHTS AND RESPONSIBILITIES

5.1 The Provider will not use the Resident's Personal Information without the Resident's written consent other than:

(a) for a purpose connected with the Residential Care to be provided to the Resident under this Agreement;

(b) for the purpose for which the Personal Information was provided by the Resident or on the Resident's behalf;

(c) for a purpose connected with Residential Care to be provided by another Provider but only to the following extent if the Resident has elected to remain covered by their existing arrangements as noted in Item 13.6 of the Pre-Admission Resident Agreement:

(i) whether the Resident has agreed to pay an Accommodation Bond; and

(ii) if so, the amount agreed and, whether wholly or partly by periodic payments, the lump sum equivalent; and

(iii) the period remaining during which retention amounts may be deducted from the Resident Accommodation Bond balance; and

(iv) amounts owing that may be deducted from the Accommodation Bond balance;

(d) otherwise as may be required by law.

5.2 The Provider must observe and the Resident must observe the Charter of Care Recipients’ (Residents’) Rights and Responsibilities defined in the Act and as contained in Schedule 2.

5.3 If the Resident has asked a person acting for care recipients to assist the Resident, the Provider must allow that person to have access to the Care Facility at any time. The Provider must

RESIDENT AGREEMENT


allow a person acting for an Authorised Body to have access to the facility during normal business hours or, if the Resident has asked for a person acting for the Authorised Body to assist the Resident, the Provider must allow that person to have access to the Care Facility at any time.

5.4 The Provider may only move the Resident to other Accommodation in the Care Facility in Accordance with Attachment One.

5.5 The Resident must not do anything that may result in the Care Facility or any fixtures or fittings in the Care Facility being damaged in any way and is liable to pay the costs of any damage caused to the Care Facility or any fixtures or fittings in the facility regardless of any cognitive impairment (fair wear and tear excepted). On termination, the Resident is liable for the costs of cleaning and, if necessary, reinstating their room to its original state (fair wear and tear excepted).

6. LEAVE FROM CARE FACILITY

6.1 From time to time the Resident may be temporarily absent from the Care Facility. The manner in which Resident Fees will be payable by the Resident whilst the resident is temporarily absent from the Care Facility will be worked out by reference to this clause 6. Whilst the Resident is temporarily absent from the Care Facility the Resident shall be taken to be on leave where the provisions of paragraphs (a), (b) or (c) apply. Where the Resident is on leave in the manner set out in paragraphs (a), (b) or (c) the Resident will nonetheless be taken during such periods to be provided with Residential Care by the Provider at the Care Facility and be required to pay the Resident Fees and other payments due under this Agreement in the manner set out in clause 2 except where otherwise set out in clause 6.3:

(a) on each day that the Resident is absent from the Care Facility whilst the Resident is

attending a hospital for the purpose of receiving hospital treatment or is receiving transition care (but not for a continuous period of 29 days or more ["extended hospital leave"]);

(b) on each day that the Resident is on extended hospital leave; and

(c) on each day that the Resident is absent from the Care Facility where:

(i) during the whole of that day, the Resident is absent from the Care Facility; and

(ii) the Resident does not, during that day, attend a hospital for the purposes of receiving hospital treatment or is receiving transition care; and

(iii) the number of days on which the Resident has previously been on leave during the financial year then current is less than 52.

6.2 For the purposes of working out the days when a Resident is on leave (or extended hospital

leave) the day upon which the period commenced is included but not the day upon which the Provider commenced or re-commenced to provide Residential Care to the Resident at the Care Facility. A Resident may be on leave for the purposes of clauses 6.1 (c) prior to Date of Entry for a period starting the later of:

(a) the day on which the Resident was notified that there was a vacancy in the Care Facility;

and

(b) the day that is seven days, or such other period as is specified in the Residential Care Principles, before the Date of Entry,

and ending on the Date of Entry.

RESIDENT AGREEMENT


6.3 Where the Resident is absent from the Care Facility for a greater period than that set out in

clause 6.1 (c) (iii) then in order to reserve the Resident's Accommodation in the Care Facility the Resident shall pay to the Provider for each such day a daily amount worked out as the sum of:

(a) the maximum daily amount of resident fee that would have been payable under clause 2.1

if the Resident was on leave in accordance with the provisions of clause 6 (but not on extended hospital leave) on that day; plus

(b) the amount that would have been the amount of the Residential Care Subsidy that would have been payable for the Resident in respect of that day, if the Resident had been provided with Residential Care through the Care Facility on that day.

7. DEFAULT

7.1. If any money due and payable by the Resident to the Provider under this Agreement (other than the Refundable Deposit) is not paid by the date upon which it is due, the Provider will be entitled to interest on such amount at the Interest Rate for the period commencing one month and one day after the day upon which the money became payable and ending on the day upon which the amount is paid, or when the Provider ceases to provide Residential Care to the Resident, whichever is the earlier.

7.2. If any money due and payable by the Resident to the Provider under this Agreement for a Refundable Deposit is not paid on the Date of Entry, the Provider is entitled to be paid interest on the Refundable Deposit at the Interest Rate whilst the Refundable Deposit remains outstanding for a period of up to six (6) months from the Date of Entry.

7.3. If the Refundable Deposit is not paid by six (6) months after the Date of Entry, the Provider will be entitled to be paid interest on the Refundable Deposit at the Interest Rate for the period ending on the day on which the amount is paid, or when the Provider ceases to provide residential care to the Resident, whichever is the earlier.

7.4. The Resident must pay all costs, charges and expenses which the Provider reasonably incurs as a result of any breach or default by the Resident under this Agreement.

7.5. The accruing and/or payment of interest on outstanding sums does not prevent the Resident from being liable to being asked to leave the Care Facility in accordance with Clause 10.3 (b) where sums other than Refundable Deposits are left unpaid for forty-two (42) days or longer, or six (6) months plus forty-two (42) days or longer in the case of Refundable Deposits amount agreed to be paid within six (6) months of Date of Entry.

8. TERMINATION GENERALLY

8.1. This Agreement may be terminated by mutual consent, confirmed in writing by the Resident or the Resident's Representative and by the Provider.

8.2. This Agreement shall terminate on the death of the Resident.

8.3. The Provider shall be entitled to terminate this Agreement on the expiry of seven days' written notice given by the Provider to the Resident if the Resident having failed to commence continuous occupation in the Care Facility on the Proposed Date of Entry does not commence occupancy within that period of seven days.

RESIDENT AGREEMENT


8.4. The Resident will not have ceased occupancy of the Care Facility for the purposes of this Agreement until such time as the Resident and all property owned by the Resident is vacated from the Care Facility.

8.5. All obligations of the Resident in relation to Resident Fees, Accommodation Payments and all other charges will survive termination of this Agreement.

9. TERMINATION BY THE RESIDENT

9.1. This Agreement may be terminated by the Resident by giving not less than seven days' notice in writing to the Provider.

9.2. If the Resident fails to give notice as prescribed in Clause 9.1, the Provider has the right to charge to the Resident the Fees that would have otherwise been payable for that period, e.g. if just three days’ notice is given by the Resident, then Fees will be payable for seven days after notice is given, which will include four days after the Resident has departed.

10. SECURITY OF TENURE

10.1. The Provider may ask the Resident to leave the Care Facility only if clauses 10.2 or 10.3 apply.

10.2. The Provider may ask the Resident to leave the Care Facility if:

(a) The Care Facility is closing; or

(b) the Care Facility no longer provides accommodation and care suitable for the Resident, having regard to the Resident's long term needs as assessed by:

(i) an Aged Care Assessment Team or (ii) by at least two medical or other health practitioners of whom one must be

independent of the Provider and the Care Facility and must be chosen by the Resident or the Resident's Representative and of whom both must be competent to assess the Resident's aged care needs, and the Provider has not agreed to provide the care of the kind that the Resident presently needs.

10.3. The Provider may ask the Resident to leave the Care Facility if the Resident:

(a) no longer needs (as assessed by an Aged Care Assessment Team) the care provided through the Care Facility; or

(b) the Resident has not paid any agreed fee to the Provider within forty-two (42) days of the day when it is payable for a reason within the Resident's control; or

(c) the Resident has intentionally caused:

(i) serious damage to the Care Facility; or

(ii) serious injury to the staff of the Provider or to another Resident;

(d) the Resident is away from the Care Facility for a continuous period of at least seven (7) days for a reason other than a reason permitted by the Act or an emergency.

10.4. The Provider may ask the Resident to leave the Care Facility temporarily if there is an

emergency situation. An emergency situation may require that a Resident relocate temporarily to alternative accommodation after evacuation.

RESIDENT AGREEMENT


11. RESIDENT’S RIGHTS UPON BEING ASKED TO LEAVE THE CARE FACILITY

11.1. If the Provider decides to ask the Resident to leave the Care Facility for any of the reasons set out in clause 10 the Provider must first give to the Resident at least 14 days' written notice before the Resident is to leave, that includes:

(a) the decision;

(b) the reasons for the decision;

(c) when the Resident is required to leave the Care Facility;

(d) the Resident's rights in relation to being asked to leave the Care Facility, including Resident’s right to access:

(i) the Provider’s complaints resolution mechanism; and

(ii) any other mechanisms available to address complaints; and

(iii) people acting for bodies that have been paid advocacy grants.

11.2. The Provider must not take action to make the Resident leave, or imply that the Resident must

leave, before suitable alternative accommodation is available that meets the Resident's assessed long-term needs and is affordable by the Resident. The assessment of the Resident's long-term needs must be assessed by an aged care assessment team or by at least two medical or other health practitioners one of whom must be independent of the Provider and the Care Facility and must be chosen by the Resident or the Resident's Representative and both of whom must be competent to assess the Resident's aged care needs.

11.3. If the Resident is required to depart from the Care Facility the Provider will provide to the Resident suggestions concerning alternative accommodation and support.

11.4. The Provider must give to the Resident a notice stating that the Resident is no longer required to leave if:

(a) the decision to require the Resident to leave was based on the Resident's behaviour; and

(b) the Provider has given the Resident a notice under clause 11.1; and

(c) after giving the notice, the Provider has agreed with the Resident that, because of a change in the behaviour, the Resident should not be required to leave the Care Facility.

12. NOTICES

12.1. Any notice or other written communication required to be given under this Agreement may be given:

(a) to the Provider if posted to or left at the address of the Provider as set out in Item 2 of the

Main Details or such other address notified in writing by the Provider to the Resident or the Resident's Representative from time to time;

(b) to the Resident if:

(i) it is posted to or delivered to the Resident's address as set out in Item 3 of the Main Details; or

(ii) given to the Resident at the Care Facility.

(c) to the Resident's Representative if it is posted to or delivered to the address shown in Item 4 of the Main Details or such other address as shall be notified in writing by the Resident's Representative to the Provider from time to time .

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12.2. Where a notice is posted it shall be deemed to have been given 48 hours after posting. If delivered by hand it shall be deemed to have been given upon delivery of the notice.

13. COSTS AND STAMP DUTY

13.1. Both the Provider and the Resident will each pay their own costs of and incidental to this Agreement.

13.2. All stamp duty (if any) on this Agreement will be paid by the Resident.

14. RULES OF RESIDENCY

The Provider is entitled to make and amend from time to time Rules of Residency for the smooth running of the Care Facility. The current Rules of Residency are as set out in Schedule 3 but it is agreed that: 14.1. to the extent that the Rules of Residency are inconsistent with any other provisions of this

Agreement or the Act they are of no force or effect.

14.2. to the extent that the Rules of Residency are consistent with this Agreement and the Act both the Provider and the Resident will abide by them.

14.3. after consultation with the Residents the Provider may vary the Rules of Residency and will bring to the Resident's attention any change in the Rules of Residency from time to time.

15. PRIVACY

15.1. The Provider will not use the Resident's Personal Information without the Resident's written consent other than as permitted by the Privacy Act 1988 (including the Australian Privacy Principles) and the Act.

16. VARIATION

16.1. This agreement may be varied:

(a) by the Provider, if the variation is necessary to implement the A New Tax System (Goods and Services Tax) Act 1999; or

(b) in any other case, by mutual consent, following adequate consultation, of the Resident and the Provider; and

16.2. That the Agreement must not be varied under sub-subparagraph 16.1 (a) unless the Provider has given reasonable notice in writing about the variation to the Resident; and

16.3. This agreement shall be deemed to have been varied to accord with any amendment of the Act from time to time, whether as to the calculation of financial entitlements or otherwise as to the rights and obligations of the Resident and the Provider under this Agreement.

16.4. This Agreement must not be varied in a way that is inconsistent with the A New Tax System (Goods and Services Tax) Act 1999, the Aged Care Act 1997 or the Extra Service Principles 2014.

RESIDENT AGREEMENT


17. COMPLAINT RESOLUTION

17.1. The Provider and the Resident will seek to resolve complaints made by or on behalf of the Resident (whether between the Resident and the Provider or between the Resident and another or other Residents) in the first instance by the process of negotiation.

17.2. If the complaint is not resolved by negotiation (a "dispute") then the parties will seek to resolve the dispute by mediation. The mediator will be chosen by agreement between the parties.

17.3. The Resident may use the advocate of their choice (such as those community based advocacy services in Attachments Three) to speak on their behalf in the first instance or, if in a “dispute”, to assist in choosing a mediator or to speak on their behalf before the mediator.

17.4. A party to the dispute is not obliged to accept the decision following mediation as final and binding.

17.5. The Resident or the Resident's Representative or anyone else has the right to make a complaint to the Secretary about anything that: (a) may be a breach of the Provider's responsibilities under the Act or the Principles; and

(b) the person making the complaint thinks is unfair or makes the Resident dissatisfied with the Care Facility.

17.6. The Secretary may attempt to resolve the complaint or dispute by means of negotiation, mediation or determination in accordance with the Act.

17.7. Complaints may also be referred to an Office of the Aged Care Complaints Scheme (The Scheme) established by the Commonwealth Government. (See Attachment Two)

18. RESIDENT’S REPRESENTATIVE

18.1. The Resident’s Representative (if any) warrants to the Provider that he/she enters into this Agreement on behalf of the Resident in consequence of the Resident being unable to enter into this Agreement because of physical or mental incapacity.

18.2. The Resident’s Representative further warrants, where an agreement to pay an

Accommodation Payment has been entered into, despite an application having been made that the Resident must not be charged a Accommodation Payment because paying the Accommodation Payment would cause the Resident financial hardship, that:

(a) to the extent that the Resident has a physical incapacity that the Resident’s Representative may sign this Agreement for the Resident; and

(b) To the extent that the Resident has a cognitive impairment, the Resident’s Representative is authorised and may sign documents for the Resident and that the Resident’s Representative is authorised to and may sign this Agreement for the Resident.

19. ENDURING POWER OF ATTORNEY

19.1. The Resident shall appoint a person to act as his or her attorney pursuant to a duly executed form of Enduring Power of Attorney and shall prior to the Date of Entry hand to the Provider the original or a duly certified copy of the Enduring Power of Attorney.

RESIDENT AGREEMENT


20. LEGAL AND FINANCIAL ADVICE AND ASSISTANCE TO UNDERSTAND

AGREEMENT

20.1. The Resident acknowledges that:

(a) the Resident has sought and obtained wholly independent legal and financial advice as to the meaning and effect of this Agreement and that the Resident or the Resident's Representative understands the meaning and effect of this Agreement; and

(b) the Resident has been informed of and been assisted by the Provider to understand the terms of this Agreement, including the Resident's rights and obligations and the care and services to be provided and the Resident Fees, Refundable Deposit, Daily Payments, Refundable Contributions, Daily Contributions and other charges and amounts payable under this Agreement by the Resident; and

(c) where this is an agreement for the Provider to provide Extra Services to the Resident through the Care Facility, the Resident has entered into this Agreement of his or her own free will and has not been subjected to any duress, misrepresentation, or threat of disadvantage or detriment and there has been no threat to cease providing care to the Resident (if already an occupant of the Care Facility) unless the Resident signs this Agreement.

21. EXTRA SERVICES

21.1. The Resident acknowledges that, where the Resident is accommodated within that distinct part, or all of, the Care Facility that has an Extra Services Status in accordance with the Act, the Resident will pay in addition to the Resident Fees otherwise payable under this Agreement the Extra Service Fee as set out in Schedule 6. The Extra Services are detailed in Schedule 5.

21.2. The accommodation, services and food specified in the conditions set out in Schedule 6 must

be provided to an Extra Services care recipient without an additional charge, other than:

(a) the approved Extra Service Fee; and

(b) items in Schedule 5 that are noted as being at a cost to the resident; and

(c) the amount of GST payable, if any, on the supply of a service:

(i) that is not a service specified in Schedule 1 to the Quality of Care Principles; and

(ii) that is provided to the care recipient on an extra service basis under section 36-1 of the Act;

21.3. The Extra Service Fee may be varied with the approval of the Secretary on the application of

the Provider in accordance with the provisions of the Act. The Act requires at the Date of Entry that the Extra Service Fee be varied not more often than annually and may be increased with the approval of the Secretary as the consequence of an application by the Provider provided that the maximum amount of such increase will be equal to 20% of the Extra Service Fee then payable plus the amount by which the Extra Services Fee then in force would change if it were indexed in accordance with the percentage change in the All Groups Price Index number (that is the weighted average of 8 capital cities) published by the Australian Statistician for the most recent twelve (12) month period before the making of the application.

21.4. The Extra Service Fee paid by the Resident cannot be increased unless the Resident is notified in writing of the proposed increase at least 30 days before the proposed increase is to take effect.

RESIDENT AGREEMENT


21.5. If an agreement for the Provider to provide Extra Services to the Resident through the Care

Facility is entered into with a Resident who was being provided with Residential Care at the Care Facility immediately before the Care Facility was granted Extra Care Status then the Resident may terminate the agreement:

(a) at any time during the 3 months after the Date of Entry; and

(b) without penalty of any kind.

21.6. If the Extra Service Status of the Care Facility is revoked or suspended, the Provider must not charge the Resident the Extra Service Fee for any period after the revocation or during the suspension. The Provider would not be required to provide the Extra Services detailed at Schedule 5 for any period after the revocation or during the suspension.

21.7. Where the Care Facility has Extra Service Status then this Agreement will be terminated if the Resident ceases to be provided with Residential Care in the Care Facility or if the Extra Service Status for the Facility ceases to have effect.

21.8. The Resident acknowledges and agrees that, if the Accommodation provided to him or her is changed ("new Accommodation") within the Care Facility (if it has Extra Service Status) or the distinct part of the Care Facility having Extra Service Status, with the Resident's consent, the Resident shall be required to pay during the period whilst the Resident is provided with new Accommodation, a revised Extra Service Fee then current for the standard of Accommodation that the Resident is provided with. The Resident acknowledges that, as at the Date of Entry, the Extra Service Fee in respect of the various standards of Accommodation within the Care Facility is as set out in Schedule 6.

22. GENERAL

22.1. If any of the provisions of this Agreement are held at law to be illegal or unenforceable (other than provisions relating to payments to be made by the Resident under this Agreement)("Payment Provisions"), they shall be severed from this Agreement to the intent that the remainder of this Agreement shall remain binding upon the Parties in accordance with its terms with the exception of the removal of such illegal or unenforceable provisions.

If any Payment Provisions are held at law to be illegal or unenforceable then they shall, at the election of the Provider, be severed from this Agreement, and the remainder of this Agreement shall remain binding upon the Parties in accordance with its terms. If the Provider elects that such Payment Provisions not be severed from this Agreement the Provider may, if permitted by the Act, terminate this Agreement

23. SPECIAL CONDITIONS

23.1. The Special Conditions (if any) set out in Schedule 7 apply to this Agreement. To the extent that any of the Special Conditions conflict with the other provisions of this Agreement the Special Conditions (subject always that they conform to the provisions of the Act) shall prevail

24. UNFUNDED PLACES

24.1. Where the proposed Resident is an Approved Care Recipient and the place in the service through which residential care will be provided to the proposed Resident is an Unfunded Place, then the proposed Resident must pay such additional amount as is specified in Item 9 in

RESIDENT AGREEMENT


the Main Details in ‘“Unfunded Places” Fee or Other agreed Amount’ in addition to any and all other fees or charges specified in this Agreement.

24.2. The maximum fee payable by the proposed Resident in an Unfunded Place is more than would have been payable if the proposed Resident’s place was a Funded Place.

25. DEFINITIONS OF WORDS USED AND INTERPRETATION

25.1. Definitions In this Agreement, unless the context otherwise requires -

"Accommodation" means the Resident's right to occupy a Room or Part of a Room in the Care Facility; “Accommodation Contribution” means the contribution payable for Accommodation in accordance with Schedule 4 where the Resident has been assessed as a Low-means Resident; “Accommodation Payment” means the agreed amount payable for Accommodation in accordance with Schedule 4; “Accommodation Supplement” means the accommodation supplement amount as determined by the Minister for a day. “ACFI” see Aged Care Funding Instrument; "Act" means the Aged Care Act 1997(Commonwealth), the Aged Care Principles and any subordinate legislation made under the Act as amended from time to time; "Additional Services" means services not included as Residential Care; "Aged Care Assessment Team" means the team responsible for determining eligibility for entry to the Care Facility of the Resident and/or the Aged Care needs of the Resident; “Aged Care Funding Instrument” (ACFI) is used for determining the level of care payments for residents in aged care homes; "Agreement" means this Agreement, and includes the Pre-Admission Resident Agreement, Main Details, the Operative Part, the relevant Schedules, and Attachments; “Approved Care Recipient” means a person who is approved under Part 2.3 of the Act as a recipient of residential care. To meet this criterion, a person would be required to hold a current residential care approval granted by an Aged Care Assessment Team for the type of Residential Care to be provided through the Care Facility; "Authorised Body" means a body that has been paid an advocacy or community visitors grant pursuant to Section 81.1 of the Act; "Basic Daily Fee" is that fee described under clause 2.6; "Base Interest Rate" means the interest rate calculated in accordance with Section 67 of the Fees and Payment Principles 2014.

RESIDENT AGREEMENT


"Care Facility" means the residential care service conducted by the Provider through which Residential Care is to be provided to the Care Resident under this Agreement being the facility mentioned in Item 6 of the Main Details; "Charter of Care Recipients’ (Residents’) Rights and Responsibilities" means the provisions set out in Schedule 2; "Classification Level" in relation to the Resident means the classification level to which the Resident has been classified in accordance with the Act and the Classification Principles; "Classification of Care" means the classification of residential care required to be provided to the Resident by the Provider determined pursuant to the Classification Principles; "Classification Principles" means the Classification Principles 1997 (as amended from time to time) being the principles to be used pursuant to the Act to classify the level of Residential Care required to be provided by the Provider to the Resident; “Daily Contribution” means the Accommodation Contribution, expressed as a daily amount, as calculated by the Department; "Daily Payment" means a daily Accommodation Payment calculated in accordance with Clause 3.1 of Schedule 4; "Date of Entry" means the date upon which the Resident enters occupation of the Care Facility being the date set out in Item 8 of the Main Details; "Department" means the Australian Government Department of Social Services and includes its successors; "Enduring Power of Attorney" means the person or organisation named in Item 5 of the Main Details; "Entry" in relation to the Resident and the Care Facility means the commencement of the provision of Residential Care to the Resident through the Care Facility and "enters" has a corresponding meaning; "Extra Service" means the standard of Accommodation, services and food to be provided to the Resident as set out in Schedule 5 or any other standard of Accommodation, services and food as notified by the Secretary to the Provider for the time being to be provided to Residents by the Provider at the Care Facility; "Extra Service Agreement" means an extra service agreement as defined in the Act; "Extra Service Fee" means the maximum additional daily fee that the Provider may from time to time charge to the Resident pursuant to the Act for providing to the Resident with Residential Care in the Care Facility on an Extra Service basis; “Extra Service Principles” means the Extra Service Principles 2014 as amended from time to time; "Extra Service Status" means the state whereby the Provider has been granted by the Secretary or otherwise, the entitlement to provide Extra Service to Residents through the Care Facility or a distinct part of the Care Facility and is entitled to charge the Extra Service Fee in respect of the Care Facility or the distinct part of the Care Facility;

RESIDENT AGREEMENT


“Funded Place” is a Resident’s place if Residential Care Subsidy is payable under Chapter 3 of the Act for the provision of care to the Resident through the Care Facility; "GST" has the meaning as in section 195-1 of the A New Tax System (Goods and Services Tax) Act 1999. "Interest Rate"’ means the rate of interest being the Maximum Permissible Interest Rate on the Date of Entry or such other lower interest rate as is specified in Item 10 of the Main Details; "Item" means an item in the Schedules or the Main Details; “Key Features Statement” means the published statement applicable at Date of Entry for the agreed Resident Room; “Low-means Resident” means a Resident who (a) is being provided with residential care through a residential care service; and

(b) is either:

(i) is eligible for accommodation supplement under section 44-28 of the Act; or (ii) on the Date of Entry, the Resident’s means tested amount was less than the maximum

accommodation supplement amount for the entry day. Note: Maximum accommodation supplement amount has the meaning given by subsection 44-21(6) of the Act. "Maximum Daily Amount of Resident Fees" means the maximum daily amount of resident fees for the Resident calculated and determined in accordance with the provisions of the Act from time to time; “Maximum Permissible Interest Rate” has the meaning given to it pursuant to the Act; “Means Tested Care Fee” has the meaning given to it pursuant to the Act; "Means Tested Amount" means the amount calculated for the Resident under section 44-22 of the Act; “Parties” means the Provider and the Resident; "Personal Information" means information or an opinion (including information or an opinion forming part of a database) whether true or not, and whether recorded in a material form or not, about an individual whose identity is apparent, or can reasonably be ascertained, from the information or opinion; "Pensioner Supplement" means the sum calculated for residents who first entered permanent residential care prior to 20 March 2008 in accordance with Part 3.1 of the Act from time to time; "Place" means a capacity within the Care Facility for provision of Residential Care to an individual; “Pre-entry Leave” means a period of up to seven days prior to Date of Entry, during which the Resident is taken to be provided with residential care by the Care Facility because the Resident was on leave under section 42-2 of the Act because of subsection 42-3(3) of the Act; “Price Agreement Day” for a Resident and a Care Facility, means the day on which the Resident and the Provider agree, under paragraph 52F-1(1)(b) of the Act, about the maximum

RESIDENT AGREEMENT


amount that would be payable if the Resident paid an Accommodation Payment for the Care Facility; "Provider" means the Provider named in Item 2 of the Main Details and includes its successors and assigns; "Prudential Arrangements", "Prudential Requirements" and "Specific Prudential Arrangement" means the arrangements put into place by the Provider pursuant to the Act relating to the treatment of the Refundable Deposit or Refundable Contribution, income derived from the Refundable Deposit or Refundable Contribution, amounts withdrawn from the Refundable Deposit or Refundable Contribution, and refunding the Refundable Deposit or Refundable Contribution; "Quality of Care Principles" means the Quality of Care Principles 2014 as amended from time to time; “Refundable Contribution” means the Accommodation Contribution that is payable in a lump sum in accordance with Schedule 4; "Refundable Deposit" means the lump sum amount payable in accordance with the provisions set out in Schedule 4 to the Provider by the Resident for entry into the Care Facility by the Resident. "Refundable Deposit Balance" means in relation to an Accommodation Payment (other than an Accommodation Payment that is to be paid by Daily Payments), an amount equal to the difference between: (a) the amount of the Accommodation Payment paid as a Refundable Deposit; and

(b) the amounts deducted or permitted to be deducted by the Provider under the Act and this Agreement.

"Refundable Deposit Equivalent" means, in relation to any portion of the Accommodation Payment which is to be paid by Daily Payments, the amount of the Refundable Deposit that the Resident would have paid if the Resident had not paid, or agreed to pay, that portion of the Accommodation Payment by Daily Payments; "Resident" means the Resident described in Item 3 of the Main Details and where relevant includes the Residents Representative named in Item 4 of the Main Details or the Resident’s Enduring Power of Attorney or Authorised Guardian named in Item 5 of the Main Details and also means the care recipient referred to in the Act; "Resident's Representative" means

(a) a person nominated by the Resident as a person to be told about matters affecting the Resident; or

(b) a person: (i) who nominates himself or herself as a person to be told about matters

affecting a Resident; and (ii) who the Provider is satisfied has a connection with the Resident and is

concerned for the safety, health and well-being of the Resident. Without limiting subparagraph (b)(ii), a person has a connection with a Resident if:

(a) the person is a partner, close relation or other relative of the Resident; or (b) the person holds an enduring power of attorney given by the Resident; or

RESIDENT AGREEMENT


(c) the person has been appointed by a State or Territory guardianship board (however described) to deal with the Resident’s affairs; or

(d) the person represents the Resident in dealings with the Provider. Note: Nothing in this definition is intended to affect the powers of a substitute decision-maker appointed for a person under a law of a State or Territory.

"Residents" is a reference to all of the residents of the Care Facility collectively; "Residential Care" means that personal care or nursing care, or both personal care and nursing care that: (a) is provided to a Resident in the Care Facility in which the Resident is also provided

with accommodation that includes:

(i) appropriate staffing to meet the nursing and personal care needs of the Resident; and

(ii) meals and cleaning services; and

(iii) furnishings, furniture and equipment for the provision of that care and accommodation; and

(b) meets any other requirements as prescribed in accordance with the Act and the Subsidy Principles and the Quality of Care Principles from time to time, including as at the date of this Agreement the care and those services set out in Parts 1 and 2 of Schedule 1 for which the Resident has need whilst residing in the Care Facility under this Agreement; and

(c) if the Resident is eligible for the services in Part 3 of Schedule One, will also include that care and those services detailed in Part 3 of Schedule One; and

(d) if the Accommodation is comprised in the Care Facility that has Extra Service Status or in the distinct part of the Care Facility that has Extra Service Status, will also include the Extra Service;

"Residential Care Subsidy" means the residential care subsidy payable to the Provider under the provisions of Division 44 of the Act as amended from time to time; "Resident Fees" and "Fees" means the aggregate sum of the fees determined in the manner set out in clauses 2 and 7 from time to time and any other fees or charges (not being an Accommodation Payment or Administrative Fee) payable by the Resident to the Provider in respect of the Residential Services to be provided to the Resident by the Provider pursuant to this Agreement; “Resident Room” or “Room” means an area that is intended to be occupied as personal space by an individual person when the Room is intended to provide accommodation for one person only or “Part of a Room” where an area of the Room that is intended to be occupied as personal space by an individual person is in a Room that is intended to provide accommodation for two or more persons. References to the “agreed Resident Room” are references to the Room specified at Item 9 of the Pre-Admission agreement; “Room Group” or “Room Type” means the grouping of Rooms that has been identified in the Care Facility for the purpose of setting an Accommodation Payment and for which a Key Features Statement must be published; "Rules of Residency" means those made by the Provider from time to time for the smooth running of the Care Facility and which outline the Resident responsibilities as a resident in the residential care service and which as at the time of this Agreement form Schedule 3;

RESIDENT AGREEMENT


"Secretary" means the Secretary of the Department; "Services" means the nursing and personal care services prescribed by the Act for the Provider to provide to the Resident at the Care Facility; "Subsidy Principles" means the Subsidy Principles 2014 as amended from time to time; “Unfunded Place” is a Resident’s place if Residential Care Subsidy otherwise payable under Chapter 3 of the Act for the provision of care for the Resident through the Care Facility is not payable because of the operation of Paragraph 42-1 (2) of the Act. Note: Under paragraph 42-1 (2) (a) of the Act, a Provider is not eligible for Residential Care Subsidy in respect of a Resident if residential care provided to the Resident is excluded (see section 42-7 of the Act) because the Provider exceeds the Provider’s allocation of places for Residential Care Subsidy; and "User Rights Principles" means the User Right Principles (2014) as amended from time to time.

25.2. Interpretation In this Agreement, unless the contrary intention appears -

(a) a reference to the Resident includes the Resident's heirs and successors and legal personal representatives;

(b) clause headings and the table of contents are inserted for convenience only and are not

to be used in the interpretation or construction of this Agreement; (c) references to a statutory enactment or regulation include references to that enactment

or regulation as amended, modified or re-enacted from time to time and include references to any enactment or regulation which by its provisions replaces an enactment or regulation so referred to;

(d) words importing any gender include all other genders;

(e) words importing the singular include the plural and vice versa;

(f) a reference to an attachment, clause, recital or schedule is a reference to an attachment

to, clause of, or recital or schedule to this Agreement;

(g) a reference to a person includes a natural person, corporation, incorporated association, statutory corporation, the Crown and any other type of legal entity; and

(h) a covenant, indemnity, warranty, agreement or representation on the part of two or

more persons binds them jointly and severally.

RESIDENT AGREEMENT


SCHEDULE 1 – SPECIFIED CARE AND SERVICES FOR RESIDENTIAL CARE

SERVICES

In signing this Agreement, the Resident or Resident's Representative acknowledges and agrees that they will be charged for the items detailed below, unless otherwise detailed below as items for which the Provider cannot charge a Resident. If there are any concerns regarding the below, please discuss with the facility manager prior to signing this Agreement. Free advice can be obtained from the Advocacy Services as listed in Attachment Three to this Agreement.

PART 1—HOTEL SERVICES—TO BE PROVIDED FOR ALL RESIDENTS WHO NEED THEM

Item and Service Content Additional Guidance

1.1

Administration

General operation of the residential care service, including documentation relating to Residents.

A Provider cannot charge a Resident for:

• registering the Resident for a place on a waiting list

• preparing the Resident Agreement

• preparing invoices and statements for the Resident’s care

• Residents Handbook

• informing the Resident of meetings

• booking fees o excludes recipients of residential

respite care

• translated material in the Resident’s preferred language explaining basic matters such as Resident Rights and Responsibilities, complaints processes, food menus, and daily activity program.

A Provider can charge a Resident for:

• management of a Resident trust account where such arrangements are voluntary o the Resident must have the choice

to handle their finances without placing their money in a trust account with the Provider.

1.2

Maintenance of buildings and grounds

Adequately maintained buildings and grounds.


• gardening

• maintenance inside and outside the residential care service

• any repairs and replacements necessary because of normal wear and tear o excludes repairs and replacements

necessary because of intentional damage.

RESIDENT AGREEMENT


SCHEDULE 1 - continued

PART 1—HOTEL SERVICES—TO BE PROVIDED FOR ALL RESIDENTS WHO NEED THEM - continued


1.3

Accommodation

Utilities such as electricity and water.


• inspection of the Provider’s electrical equipment for work health and safety purposes o includes testing and tagging of

electrical equipment

• telephone sockets

• access to a pay telephone

• heating and cooling the residential care service to provide a comfortable environment for Residents o excludes running costs of personal

heating or cooling units provided and operated by the Resident in addition to an effective heating or cooling system provided by the residential care service

• moving a Resident from one bed or room to another within the residential care service when the move is not at the Resident’s request o conditions apply to moving a

Resident within the residential care service – see section 10 of the User Rights Principles 2014 and section 17 of the Fees and Payments Principles 2014 (No.2) for details.

See also Attachment One of this Agreement.

1.4

Furnishings

Bedside lockers, chairs with arms, containers for personal laundry, dining, lounge and recreational furnishings, draw-screens (for shared rooms), wardrobe space and towel rails.

Excludes furnishings a Resident chooses to provide.


• a chair with arms to meet the Resident’s care, safety and comfort needs o if the Resident is unable to walk or

move about independently and cannot use a conventional arm chair, includes an arm chair with particular features to meet the Resident’s needs, such as an air, water or gel chair.

RESIDENT AGREEMENT





1.5

Bedding

Beds and mattresses, bed linen, blankets, and absorbent or waterproof sheeting.


• a bed, a mattress and pillows that meet the Resident’s care, safety and comfort needs o includes as required a bed with

particular features that meets the Resident’s needs, for example to accommodate the Resident’s height or weight.

1.6

Cleaning services, goods and facilities

Cleanliness and tidiness of the entire residential care service. Excludes a Resident’s personal area if the Resident chooses and is able to maintain this himself or herself.


• cleaning the Resident’s room and ensuite

o includes any cleaning materials for the use of the Resident if the Resident chooses to maintain their personal area

• cleaning floor coverings

o includes carpets.

1.7

Waste disposal

Safe disposal of organic and inorganic waste material.


• safe disposal of sharps and contaminated waste.

1.8

General laundry

Heavy laundry facilities and services, and personal laundry services, including laundering of clothing that can be machine washed.

Excludes cleaning of clothing requiring dry cleaning or another special cleaning process, and personal laundry if a resident chooses and is able to do this himself or herself.


• general laundry, including washing and ironing clothing that can be machine washed o excludes hand-washing items of the

Resident’s clothing

• a system to identify the Resident’s laundry items o excludes an effective alternative

system of the Resident’s own choice

o for example, a Provider may charge a resident additional fees if the Resident requests use of woven name tapes when the Provider normally uses a laundry marking pen to ensure identification of Residents’ laundry.

RESIDENT AGREEMENT





1.9

Toiletry goods

Bath towels, face washers, soap, toilet paper, tissues, toothpaste, toothbrushes, denture cleaning preparations, mouthwashes, moisturiser, shampoo, conditioner, shaving cream, disposable razors and deodorant.


• suitable soap, or soap substitute, if the Resident’s care needs mean the Resident cannot use the soap normally provided.

• denture cleaning products. o excludes personal denture

containers.

1.10

Meals and refreshments

(a) Meals of adequate variety, quality and quantity for each resident, served each day at times generally acceptable to both residents and management, and generally consisting of 3 meals per day plus morning tea, afternoon tea and supper;

(b) Special dietary requirements, having regard to either medical need or religious or cultural observance;

(c) Food, including fruit of adequate variety, quality and quantity, and non-alcoholic beverages, including fruit juice.


• quality food in accordance with the Resident’s individual nutritional needs o includes consultation with

Residents in menu planning.

• special dietary items to meet the Resident’s individual medical, cultural or religious needs o includes, for example, vegetarian,

kosher, halal food to meet cultural or religious needs.

o includes gluten free food, low fat food and thickened drinks to meet medical needs.

o includes nutritional supplements, if the Resident is assessed by an appropriate health practitioner1 as requiring a special dietary supplement to ensure their adequate nutrition and hydration.

1.11

Resident social activities

Programs to encourage residents to take part in social activities that promote and protect their dignity, and to take part in community life outside the residential care service


• developing and delivering social activity programs in accordance with the Resident’s needs, wishes and abilities. o includes consultation with the

Resident and/or their representative in program planning.

o excludes outing costs, for example transport, entry fees and purchased food.

1.12

Emergency assistance

At least one responsible person is continuously on call and in reasonable proximity to render emergency assistance

Consider the number of Residents and their dependency levels in deciding the number and qualifications of emergency assistance personnel available.

RESIDENT AGREEMENT



PART 2—CARE AND SERVICES—TO BE PROVIDED FOR ALL RESIDENTS WHO NEED THEM


2.1

Daily living activities assistance

Personal assistance, including individual attention, individual supervision, and physical assistance, with the following:

(a) bathing, showering, personal hygiene and grooming;

(b) maintaining continence or managing incontinence, and using aids and appliances designed to assist continence management;

(c) eating and eating aids, and using eating utensils and eating aids (including actual feeding if necessary);

(d) dressing, undressing, and using dressing aids;

(e) moving, walking, wheelchair use, and using devices and appliances designed to aid mobility, including the fitting of artificial limbs and other personal mobility aids;

(f) communication, including to address difficulties arising from impaired hearing, sight or speech, or lack of common language (including fitting sensory communication aids), and checking hearing aid batteries and cleaning spectacles.

Excludes hairdressing


• ensuring that all personal care needs are assessed and met

• non-custom made assistive devices, available for use as and when required, that enable the Resident to maintain activities of daily living o excludes mobility aids and

continence aids, see

Item 3.4 Goods to assist care recipients to move themselves

Item 3.6 Goods to assist with toileting and incontinence management.

2.2

Meals and refreshments

Special diet not normally provided.


• medically prescribed special diets or components of such diets o includes enteral feeding formula if

needed.

If supported by medical certification of the Resident’s ongoing need, financial assistance may be available through the Enteral Feeding Supplement2 for enteral feeding formula provided enterally.

See also:

Item 1.10 Meals and refreshments

RESIDENT AGREEMENT


SCHEDULE 1 – continued

PART 2—CARE AND SERVICES—TO BE PROVIDED FOR ALL RESIDENTS WHO NEED THEM - continued


2.3

Emotional support

Emotional support to, and supervision of, Residents.


• individual support in adjusting to life in the new environment and on an ongoing basis as required

• individual support in exercising rights under the Charter of Care Recipients’ (Residents’) Rights and Responsibilities

• access to support through counsellors, health practitioners1, chaplains, community visitors and advocacy services. o excludes professional counselling

fees.

2.4

Treatments and procedures

Treatments and procedures that are carried out according to the instructions of a health professional or a person responsible for assessing a Resident’s personal care needs, including supervision and physical assistance with taking medications, and ordering and reordering medications, subject to requirements of State or Territory law.

Includes bandages, dressings, swab and saline.


• nurses coming into the residential care service to provide treatment in accordance with the Resident’s assessed needs o includes community or agency

nurses carrying out tasks such as administration of regular injections, such as insulin injections, or provision of complex wound care

• physical assistance with taking both prescription and over the counter medicines, and ordering and reordering both prescription and over the counter medicines

• a system for safe ordering, reordering, storage and administration of medicines in accordance with relevant legislation o includes a medicine packaging

system that forms part of the residential care service’s chosen medicine administration system

o excludes a different medicine administration system of the Resident’s personal choice.

• bandages and dressings required as part of treatments and procedures according to the instructions of a health professional1.

A Provider may charge a Resident for:

• costs of medicines, whether prescription or over the counter.

RESIDENT AGREEMENT





2.5

Recreational therapy

Recreational activities suited to Residents, participation in the activities, and communal recreational equipment.


• developing and delivering recreational activity programs that meet the Resident’s clinical needs, capabilities and preferences o includes consultation with the

Resident and/or their representative in program planning

o includes catering to minority interests

o excludes outing costs, for example transport, entry fees and purchased food

• communal recreation equipment.

2.6

Rehabilitation support

Individual therapy programs designed by health professionals that are aimed at maintaining or restoring a Resident’s ability to perform daily tasks for himself or herself, or assisting Residents to obtain access to such programs.


• an appropriate health practitioner1, such as a physiotherapist, occupational therapist or nurse practitioner, to assess the Resident’s rehabilitation support needs and to design a rehabilitation program o includes discussion with the

Resident and/or their representative about achievable goals

o includes appointments at the residential care service or at the health practitioner’s1 premises

o excludes delivery of the program – for requirements to deliver therapy services see Item 3.11 Therapy services.

See also:

• Item 2.8 Assistance in obtaining access to specialised therapy services

• Item 3.11 Therapy services

RESIDENT AGREEMENT





2.7

Assistance in obtaining health practitioner services

Arrangements for aural, community health, dental, medical, psychiatric and other health practitioners to visit Residents, whether the arrangements are made by Residents, relatives or other persons representing the interests of Residents, or are made direct with a health practitioner.


• as required by the Resident’s needs, making arrangements for a health practitioner1 to visit the Resident at the residential care service or for the Resident to visit the health practitioner1

at their location o includes, but is not limited to,

primary care, allied health, dental, and specialist health practitioners1

o includes arranging transport and escort of the Resident to and from appointments

o excludes costs of transport and/or escort of the Resident to and from appointments.

2.8

Assistance in obtaining access to specialised therapy services

Making arrangements for speech therapists, podiatrists, occupational or physiotherapy practitioners to visit Residents, whether the arrangements are made by Residents, relatives or other persons representing the interests of Residents.


• as required by the Resident’s needs, making arrangements for a health practitioner1 to visit the Resident at the residential care service or for the Resident to visit the health practitioner1 at their location o includes arranging transport and

escort of the Resident to and from appointments

o excludes costs of transport and/or escort of the Resident to and from appointments.

See also:

• Item 2.6 Rehabilitation support

• Item 3.11 Therapy services

2.9

Support for residents with cognitive impairment

Individual attention and support to Residents with cognitive impairment (eg. dementia, and behavioural disorders), including individual therapy activities and specific programs designed and carried out to prevent or manage a particular condition or behaviour and to enhance the quality of life and care for such Residents and ongoing support (including specific encouragement) to motivate or enable such Residents to take part in general activities of the residential care service.


• developing and delivering programs that meet the Resident’s needs and preferences, to reduce the incidence of behavioural and psychological symptoms of dementia and/or other conditions, and to enhance the quality of life and care for the Resident.

RESIDENT AGREEMENT



PART 3—CARE AND SERVICES—TO BE PROVIDED FOR ELIGIBLE RESIDENTS ONLY


Note re: eligibility for these Part 3 services: These Services in Part 3 detail services that are provided at no additional cost for the following Residents:

(a) a Resident whose ACFI classification level includes any of the following: (i) high ADL domain category; (ii) high CHC domain category; (iii) high behaviour domain category; (iv) a medium domain category in at least 2 domains;

(b) a Resident whose classification level is high level residential respite care; (c) a Resident for whom there is no classification (d) a continuing Resident who on 19 March 2008 was receiving a high level of residential care;

Other Residents who access these services will be asked to pay for the services.

3.1

Furnishings

Over-bed tables

3.2

Bedding materials

Bed rails, incontinence sheets, ripple mattresses, sheepskins, tri-pillows, and water and air mattresses appropriate to each Resident’s condition.

A Provider cannot charge a Resident exempt from additional fees for this Item for:

• bedding materials with particular features that meet the Resident’s individual needs as assessed by an appropriate health practitioner1 o includes pressure relieving items of

suitable type and quality, such as water, air and gel cushions.

3.3

(Deleted)

3.4

Goods to assist residents to move themselves

Crutches, quadruped walkers, walking frames, walking sticks, and wheelchairs.

Excludes motorised wheelchairs and custom made aids


• use, as and when required, of a non-motorised wheelchair that meets pressure care requirements and optimises levels of mobility and participation o excludes customised aids designed

and made for the sole use of the resident, for example tailor made arm splints, hand splints and/or leg splints, or a customised wheelchair (motorised or not motorised).

RESIDENT AGREEMENT



PART 3—CARE AND SERVICES—TO BE PROVIDED FOR ELIGIBLE RESIDENTS ONLY - continued


3.5

Goods to assist staff to move residents

Mechanical devices for lifting Residents, stretchers, and trolleys.


• access to and use as required of fit-for-purpose lifting devices, such as lifting machines and standing machines, operated by staff trained in their use in accordance with work health and safety obligations o slings and other equipment used in

the operation of lifting devices.

3.6

Goods to assist with toileting and incontinence management

Absorbent aids, commode chairs, disposable bed pans and urinal covers, disposable pads, over-toilet chairs, shower chairs and urodomes, catheter and urinary drainage appliances, and disposable enemas.


• individual assessment by a health practitioner1 of the Resident’s continence needs

• continence products to manage the resident’s assessed toileting and continence needs.

Residents who are not exempt from additional fees for this Item and who meet the eligibility criteria may participate in the Continence Aids Payment Scheme3.

Stoma related products and supplies are available free of charge through the Stoma Scheme4 to any eligible Resident.

3.7

(Deleted)

RESIDENT AGREEMENT




Item and Service Content Additional Guidance 3.8 Nursing services Initial assessment and care planning

carried out by a nurse practitioner or registered nurse, and ongoing management and evaluation carried out by a nurse practitioner, registered nurse or enrolled nurse acting within their scope of practice. Nursing services carried out by a nurse practitioner, registered nurse or enrolled nurse, or other professional appropriate to the service (e.g. medical practitioner, stoma therapist, speech pathologist, physiotherapist or qualified practitioner from a palliative care team), acting within their scope of practice. Services may include, but are not limited to, the following: (a) establishment and supervision

of a complex pain management or palliative care program, including monitoring and managing any side effects;

(b) insertion, care and maintenance of tubes, including intravenous and naso-gastric tubes;

(c) establishing and reviewing a catheter care program, including the insertion, removal and replacement of catheters;

(d) establishing and reviewing a stoma care program;

(e) complex wound management; (f) insertion of suppositories; (g) risk management procedures

relating to acute or chronic infectious conditions;

(h) special feeding for Residents with dysphagia (difficulty with swallowing);

(i) suctioning of airways; (j) tracheostomy care; (k) enema administration; (l) oxygen therapy requiring

ongoing supervision because of a Resident’s variable need;

(m) dialysis treatment.

A Provider cannot charge a Resident exempt from additional fees for this Item for: • assessment, planning, management,

delivery and evaluation of nursing services according to the Resident’s clinical needs o the example nursing services in

the Schedule are not exhaustive • nursing services or nursing

consultancy services o includes when the residential care

service employs a nurse practitioner or nurse consultant for advice on specialist nursing care

• administration of oxygen in response to the Resident’s variable needs o includes short term, episodic and

emergency oxygen administration and ongoing oxygen administration as needed.

o includes any oxygen consumed.

Where a Resident has an ongoing need for oxygen treatment, financial assistance is available through the Oxygen Supplement2. Stoma related products and supplies are available free of charge through the Stoma Scheme4 to any eligible resident. See also Note on the last page of this Schedule

RESIDENT AGREEMENT





3.9

(Deleted)

3.10

(Deleted)

3.11

Therapy services, such as, recreational, speech therapy, podiatry, occupational, and physiotherapy services

(a) Maintenance therapy delivered by health professionals, or care staff as directed by health professionals, designed to maintain Residents’ levels of independence in activities of daily living.

(b) More intensive therapy delivered by health professionals, or care staff as directed by health professionals, on a temporary basis that is designed to allow Residents to reach a level of independence at which maintenance therapy will meet their needs

Excludes intensive, long-term rehabilitation services required following, for example, serious illness or injury, surgery or trauma.


• a health practitioner1 to assess the resident’s therapy needs and to design an appropriate therapy program

• subsequent delivery of therapy services by the assessing health practitioner1, or by staff under the direction of the assessing health practitioner1 in accordance with applicable law o includes transporting and/or

escorting the resident to receive therapy services, where the provider chooses as its business model to deliver off-site any maintenance and/or short-term intensive therapy services that form part of the resident’s therapy program.

See also:

• Item 2.6 Rehabilitation support

• Item 2.8 Assistance in obtaining access to specialised therapy services

3.12

(Deleted)

RESIDENT AGREEMENT


SCHEDULE 1 - continued Endnotes 1 ‘Health professional’ and ‘health practitioner’ includes, but is not limited to, a member of the following professions when working within their scope of practice:

• Aboriginal and Torres Strait Islander Health Worker

• Audiologists • Dentists • Dieticians • Diversional Therapists

• Exercise Physiologists • Doctors • Nurses • Occupational Therapists • Optometrists • Pharmacists • Physiotherapists

• Podiatrists • Psychiatrists • Psychologists • Social Workers • Speech Pathologists.

If a profession is regulated through the Health Practitioner National Regulation Law 2009, the scope of practice is that established by the National Board for the profession.

‘Health professional’ and ‘health practitioner’ does not include: • Assistants-in-Nursing and Personal Care Workers (however titled) • Therapy Assistants (however titled).

2 See http://www.medicareaustralia.gov.au/provider/aged-care/forms.jsp 3 See http://www.bladderbowel.gov.au/caps 4 See http://www.health.gov.au/internet/main/publishing.nsf/Content/Stoma+Appliance+Scheme-3 Note re: Role and Scope of Practice of Registered Nurses and Enrolled Nurses The role and scope of practice of registered nurses (including nurse practitioners) and enrolled nurses is described in the Nursing and Midwifery Board of Australia’s National Competency Standards for the Registered Nurse and National Competency Standards for the Enrolled Nurse. (http://www.nursingmidwiferyboard.gov.au/) The registered nurse practices independently and interdependently, including delegating care to enrolled nurses and health care workers. The registered nurse assesses, plans, implements and evaluates nursing care in collaboration with individuals and the multidisciplinary health care team to achieve goals and health outcomes. The enrolled nurse is an associate to the registered nurse and works under the direction and supervision of the registered nurse. Under assessment and care planning, the enrolled nurse may contribute to the formulation of care plans through: • the collection and reporting of data regarding the health and functional status of individuals and groups; • participating with the registered nurse in identifying expected health outcomes; and • participating with the registered nurse in evaluation of progress toward expected health outcomes and

reformulation of care plans.

RESIDENT AGREEMENT


SCHEDULE 2 – CHARTER OF CARE RECIPIENTS’ (RESIDENTS’) RIGHTS AND RESPONSIBILITIES

Clause 5.2

Please refer to the following pages


.

Charter of Care Recipients’ (Residents’) Rights

and Responsibilities – Residential Care

Aged Care Act 1997, Schedule 1 User Rights Principles 2014


1. Care Recipients’ (Residents’) Rights - Residential Care Each care recipient has the following rights:

a) to full and effective use of his or her personal, civil, legal and consumer rights; b) to quality care appropriate to his or her needs; c) to full information about his or her own state of health and about available

treatments; d) to be treated with dignity and respect, and to live without exploitation, abuse or

neglect; e) to live without discrimination or victimisation, and without being obliged to feel

grateful to those providing his or her care and accommodation; f) to personal privacy; g) to live in a safe, secure and homelike environment, and to move freely both

within and outside the residential care service without undue restriction; h) to be treated and accepted as an individual, and to have his or her individual

preferences taken into account and treated with respect; i) to continue his or her cultural and religious practices, and to keep the language

of his or her choice, without discrimination; j) to select and maintain social and personal relationships with anyone else

without fear, criticism or restriction; k) to freedom of speech; l) to maintain his or her personal independence; m) to accept personal responsibility for his or her own actions and choices, even

though these may involve an element of risk, because the care recipient has the right to accept the risk and not to have the risk used as a ground for preventing or restricting his or her actions and choices;

n) to maintain control over, and to continue making decisions about, the personal aspects of his or her daily life, financial affairs and possessions;

o) to be involved in the activities, associations and friendships of his or her choice, both within and outside the residential care service;

p) to have access to services and activities available generally in the community; q) to be consulted on, and to choose to have input into, decisions about the living

arrangements of the residential care service; r) to have access to information about his or her rights, care, accommodation

and any other information that relates to the care recipient personally; s) to complain and to take action to resolve disputes; t) to have access to advocates and other avenues of redress; u) to be free from reprisal, or a well-founded fear of reprisal, in any form for taking

action to enforce his or her rights.


2. Care Recipients’ (Residents’) Responsibilities - Residential Care Each care recipient has the following responsibilities:

a) to respect the rights and needs of other people within the residential care service, and to respect the needs of the residential care service community as a whole;

b) to respect the rights of staff to work in an environment free from harassment; c) to care for his or her own health and well-being, as far as he or she is capable; d) to inform his or her medical practitioner, as far as he or she is able, about his

or her relevant medical history and current state of health.

RESIDENT AGREEMENT


SCHEDULE 3 – RULES OF RESIDENCY

Clause 14

(Here add or insert any Rules of Residency - if none write "NIL")

RESIDENT AGREEMENT


SCHEDULE 4 – ACCOMMODATION PAYMENT & ACCOMMODATION CONTRIBUTION

Clause 5

The following provisions relate to the Accommodation Payment and the Accommodation Contribution: 1. THE AMOUNT OF THE ACOMMODATION PAYMENT 1.1. The Resident will pay the Accommodation Payment by Refundable Deposit or by Daily

Payments or by a combination of both shown in Item 12, 13 or 14 of the Main Details in accordance with the provisions of clause 4 of the Agreement.

1.2. The Resident acknowledges and agrees that:

(a) the Accommodation Payment has been calculated in accordance with the provisions of the Act based upon the information provided by the Resident (including without limitation the information set out in Attachment Four to this Agreement); and

(b) if the information provided is inaccurate, then (in addition to all and any other rights the Provider may have as a consequence) the Provider will reassess the Accommodation Payment (if any) payable by the Resident in accordance with the Act; and

(c) the Accommodation Payment has been calculated based on the Resident occupying the agreed Resident Room. If the Resident moves to a different room in the Care Facility then the Accommodation Payment will be adjusted in accordance with the provisions set out in Attachment One.

2. THE RESIDENT'S RIGHT TO ELECT THE MANNER OF PAYMENT 2.1 Within 28 days of Date of Entry, the Resident must choose to pay the Accommodation

Payment by:

(a) Refundable Deposit; or

(b) Daily Payment; or

(c) A combination of Refundable Deposit and Daily Payment

2.2 If the Resident does not choose how to pay within those 28 days, the Resident must pay the Accommodation Payment by Daily Payment.

2.3 Daily Payments are payable from the Date of Entry on any outstanding Accommodation Payment amount.

3. DAILY PAYMENTS 3.1 Daily Payments are worked out in accordance with the following formula:

DP = LSE x IR 365

RESIDENT AGREEMENT


where: IR is the Interest Rate referred to in Item 10 of the Main Details; DP is the amount of the Daily Payment; LSE (Lump Sum Equivalent) is the agreed Accommodation Payment (expressed as a Refundable Deposit amount) less any amount of Refundable Deposit held on that day for the Room or part of the Room.

3.2 The Provider is entitled to retain the whole of the amount of the Accommodation Payment paid by way of Daily Payments.

3.3 Daily Payments are payable fortnightly or monthly in advance as specified by the Provider.

3.4 Despite the Resident's election to pay any part of the Accommodation Payment by Daily Payment the Resident may at any time pay as a Refundable Deposit all or any part of the Refundable Deposit Equivalent.

4. REFUNDABLE DEPOSIT 4.1 If the Resident elects to pay the Accommodation Payment in one lump sum, called the

Refundable Deposit, the whole of the Refundable Deposit must be paid no later than six (6) months from the Date of Entry.

4.2 The maximum Refundable Deposit that a Resident can pay cannot exceed an amount that would reduce the Resident’s remaining assets to less than $45,500.

4.3 Where the Accommodation Payment is above the amount the Resident could pay as a

Refundable Deposit and still be left with $45,500 in remaining assets, then the Resident must pay the balance of the Accommodation Payment as a Daily Payment.

4.4 The Daily Payment is payable on any unpaid portion of the Accommodation Payment from the Date of Entry until the Accommodation Payment is paid in full as a Refundable Deposit.

4.5 Part or all of the Accommodation Payment can be paid as a Refundable Deposit at any time.

4.6 Any amount paid as a Refundable Deposit can be returned to the Resident and be paid instead as a Daily Payment with the prior written approval of the Provider.

5. COMBINATION OF REFUNDABLE DEPOSIT PLUS DAILY PAYMENTS 5.1 If the Resident elects to pay the Accommodation Payment partly by Refundable Deposit and

partly by Daily Payments then:

(a) The agreed Refundable Deposit amount must be paid on or before six (6) months from the Date of Entry; and

(b) The Daily Payment must be paid from the Date of Entry on the total outstanding Accommodation Payment amount, (including the agreed Refundable Deposit amount which has not yet been paid) until the agreed Refundable Deposit amount has been paid; and

RESIDENT AGREEMENT


(c) When the agreed Refundable Deposit amount has been paid, Daily Payments must continue to be paid on the balance of the Accommodation Payment.

5.2 The agreed combination as at Date of Entry is detailed in this item 14 of the Main Details

5.3 Despite the Resident's election to pay any part of the Accommodation Payment by Daily

Payments, the Resident may at any time pay as a Refundable Deposit all or any part of the Refundable Deposit Equivalent.

5.4 The Provider is entitled to retain the whole of the amount of the Accommodation Payment

paid by way of Daily Payments.

6. DAILY PAYMENTS WITHDRAWN FROM REFUNDABLE DEPOSIT 6.1 If the Resident pays a Refundable Deposit, the Provider:

(a) must, at the Resident’s request, deduct Daily Payments from the Refundable Deposit; and

(b) requires the Resident to maintain the agreed Accommodation Payment if the Refundable Deposit is reduced.

6.2 To maintain the agreed Accommodation Payment because the Refundable Deposit has been

reduced, the Resident may do so by:

(a) paying Daily Payments or increased Daily Payments; or (b) topping up the Refundable Deposit; or (c) a combination of both.

6.3 The Resident may not top up the Refundable Deposit if to do so would reduce the Resident’s

remaining assets as at Date of Entry to less than $45,500.

6.4 Interest can be charged as the Refundable Deposit is reduced by the withdrawal of Daily Payments. As the Refundable Deposit is reduced, the amount withdrawn in Daily Payments is added to the outstanding Refundable Deposit amount and the Interest Rate is applied to this total amount. This will result in an increase to the Daily Payment. This increase to the Daily Payment compensates the Provider for the financial impact of receiving lower earnings due to decreasing the Refundable Deposit balance.

7. DEDUCTIONS FROM REFUNDABLE DEPOSIT

7.1 The Provider will be entitled to deduct, retain or be paid from the Refundable Deposit the

following amounts:

(a) Any Daily Payment amounts which the Resident has requested to be withdrawn from the Refundable Deposit

(b) Any amounts which the Resident has agreed to pay to the facility in the agreement or any Extra Services Agreement where the amounts are still outstanding at the time the Resident leaves the Care Facility. These amounts may include any Fees agreed to be left outstanding and to be retained from the lump sum Refundable Deposit before refund.

(c) Any other amounts agreed between the Provider and the Resident, including, but not limited to, Basic Daily Fees, Means Tested Care Fees and/or Unfunded Places Fees.

(d) Amounts representing interest on the above, worked out in accordance with the Act.

RESIDENT AGREEMENT


8. ACCOMMODATION CONTRIBUTIONS 8.1 Within 28 days of Date of Entry the Resident must choose to pay the Accommodation

Contribution by:

(a) Daily Contributions; or (b) Refundable Contribution; or (c) A combination of Refundable Contribution and Daily Contributions.

8.2 If the Resident does not choose how to pay within 28 days of Date of Entry, the Resident must pay the Accommodation Contribution by Daily Contribution.

8.3 Daily Contributions are payable from the Date of Entry at the Accommodation Contribution amount set by the Department for the Resident less any allowance for any Refundable Contribution once that Refundable Contribution has been paid.

8.4 Accommodation Contributions are determined by the Department and may increase or

decrease from time to time as advised by the Department.

8.5 The Accommodation Contribution for a day must not exceed the Resident’s Means-Tested Amount, which is an amount determined by DHA (Centrelink) or DVA and is applicable for Low-means Residents.

8.6 The Accommodation Contribution will increase or decrease from time to time depending on:

(a) The Accommodation Supplement applicable to the Care Facility, and/or

(b) The Resident’s Means-Tested Amount.

8.7 The Accommodation Supplement can vary depending on:

(a) whether or not the Care Facility has more than 40% of its permanent Residents as Low-means Residents (or concessional, assisted, partially-supported or fully-supported Residents), and/or

(b) whether or not the Care Facility is eligible for a higher Accommodation Supplement applicable to new or significantly refurbished Care Facilities.

8.8 The Residents Means-Tested Amount can vary dependent on deeming rates; levels of

assessable assets; and many other reasons. Most Residents who are part-pensioners can expect their Means-Tested Amount to vary every quarter (i.e. four times per year)

8.9 The maximum Refundable Contribution that a Resident could pay is calculated as follows:

MRC = MDC x 365 MPIR MRC is the maximum Refundable Contribution MDC is the maximum Daily Contribution as advised by the Department MPIR is the Maximum Permissible Interest Rate

8.10 The maximum Refundable Contribution that a Resident can pay cannot exceed an amount that

would reduce the Resident’s remaining assets as at Date of Entry to less than $45,500.

RESIDENT AGREEMENT


8.11 Where the maximum Refundable Contribution is above the amount the Resident could pay and still be left with $45,500 in remaining assets as at Date of Entry, then the Resident must pay the balance of the Maximum Refundable Contribution as a Daily Contribution.

8.12 The part of a maximum Refundable Contribution that cannot be paid as Refundable Contribution will be recalculated as a Daily Contribution as follows:

(a) Subtract the part Refundable Contribution that has been paid from the maximum Refundable Contribution; and

(b) Multiply the result by the MPIR and divide it by 365. 8.13 If the Resident elects to deduct the Daily Contribution from the Refundable Contribution, then

the Resident is subject to interest on the reducing Refundable Contribution balance which can be paid by increasing the Daily Contribution amount to include interest or by topping up a Refundable Contribution or by a combination of Refundable Contribution and Daily Contribution.

8.14 If the amount of the Accommodation Contribution that is payable increases, the Provider will require the Resident to pay the increase and the Resident may do so by :

(i) paying Daily Contributions or increased Daily Contributions; or (ii) paying or topping up a Refundable Contribution; or (iii) a combination of both.

8.15 The Resident is to make an election as to whether to pay an Accommodation Contribution by Refundable Contribution or Daily Contribution or a combination of the two until within 28 days of the Date of Entry.

8.16 Interest will be charged as the Refundable Contribution is reduced by the withdrawal of Daily Contribution. As the Refundable Contribution is reduced, the amount withdrawn in Daily Contributions is added to the outstanding Refundable Contribution amount and the Interest Rate is applied to this total amount. This will result in an increase to the Daily Contribution. This increase to the Daily Contribution compensates the Provider for the financial impact of receiving lower earnings due to decreasing the Refundable Contribution balance.

9. REFUND OF REFUNDABLE DEPOSIT OR REFUNDABLE CONTRIBUTION

BALANCE 9.1 The Refundable Deposit or Refundable Contribution Balance must be refunded by the

Provider if:

(a) the Resident dies (Subject to clause 9.4); or

(b) the Resident ceases to be provided with Accommodation and Residential Care at the Care Facility (other than because the Resident is on leave).

9.2 The Refundable Deposit or Refundable Contribution Balance must be refunded:

(a) if the Resident enters another residential care service:

(i) if the Resident has notified the Provider more than 14 days before the day on which the Provider ceases providing Residential Care for the Resident - on the day on which the Provider ceases providing that Residential Care; or

(ii) if the Resident so notified the Provider within 14 days before the day on which the Provider ceases providing Residential Care - within 14 days after the day on

RESIDENT AGREEMENT


which the Resident notified the Provider of intending to move to another residential care service or

(iii) if the Resident did not notify the Provider before the day on which the Provider ceases providing Residential Care - within 14 days after the day on which the Provider ceases providing Residential Care; and

(b) in any other case (subject to clause 9.4) - within 14 days after the day on which the event referred to in clause 9.1 (a), (b) or (c) happens.

9.3 The Resident's Room and the Care Facility must be vacated before the day upon which the

refund is payable under clause 9.2 except in the event referred to in clause 9.1 (c). 9.4 It is a requirement of the Provider that no repayment of any part of the Refundable Deposit or

Refundable Contribution Balance will be made to any representative of any deceased Resident before a certified copy of a Grant of Probate or Letters of Administration of the estate of the deceased Resident is received by the Provider. The Provider shall pay the amount of the Refundable Deposit or Refundable Contribution Balance within 14 days after the receipt of a certified copy of the Grant of Probate or Letters of Administration.

9.5 The Provider is required to pay interest on the Refundable Deposit or Refundable Contribution Balance for the period from the day after the Resident leaves the Care Facility until the Refundable Deposit or Refundable Contribution Balance is refunded. The Provider will pay interest at two different rates:

(a) at the Base Interest Rate (BIR) for the period between the Resident's departure and the completion of the legislated timeframe for refunding the Refundable Deposit or Refundable Contribution or;

(b) at the Maximum Permissible Interest Rate (MPIR) for the period after the end of the legislated timeframe until the Refundable Deposit or Refundable Contribution Balance is refunded

9.6 If the Resident ceases to be provided with Residential Care at the Care Facility (other than

because the Resident is on leave) the Resident may agree with the Provider to delay refunding the Refundable Deposit or Refundable Contribution Balance on condition that, if the Resident requests re-entry to the Care Facility:

(a) the Provider must allow entry if:

(i) there are any places vacant in the Care Facility;

(ii) the Resident has been approved under Part 2.3 of the Act as a recipient of Residential Care; and

(b) an Accommodation Payment is not payable in respect of that re-entry.

10. REFUND OF OVERPAID ACCOMMODATION PAYMENT OR

ACCOMMODATION CONTRIBUTION.

10.1 In the event that Resident has paid a higher amount of Accommodation Payment or Accommodation Contribution than was properly payable, the Provider must refund to the Resident the difference (the overpaid amount) between the amount of Accommodation Payment or Accommodation Contribution that was properly payable and the amount of Accommodation Payment or Accommodation Contribution that was paid.

10.2 The Resident may request the Provider, in writing, to refund the overpaid amount to the Resident.

RESIDENT AGREEMENT


10.3 If the Provider does not refund the overpaid amount to the Resident within 28 days after the earlier of:

(a) the day the Provider becomes aware of the overpaid amount; and

(b) if the Resident makes a request under Item 10.2—the day the Provider receives the request;

the Provider must pay an amount of interest relating to the overpaid amount, worked out in accordance with the following formula:

MPIR x OA x ND(PP)

365 where: MPIR is the maximum permissible interest rate for the day that is 28 days after the day referred to in paragraph (a) or (b) (as the case requires) of this clause, worked out using the calculator in section 6 of the Fees and Payments Principles 2014 (No.2) ND(PP) is the number of days in the period: (a) beginning on the day that is 28 days after the day referred to in paragraph (a) or (b) (as the

case requires) of this Clause; and (b) ending on the day on which the overpaid amount is refunded.

OA is the overpaid amount.

11. CONDITIONS APPLYING IF THE RESIDENT AGREES TO PAY A REFUNDABLE

DEPOSIT OR REFUNDABLE CONTRIBUTION BUT DOES NOT ENTER CARE FACILITY

11.1 If the Resident doesn’t enter the Care Facility, and has paid a Refundable Deposit or

Refundable Contribution, the entire Refundable Deposit or Refundable Contribution will be refunded to the Resident.

12. APPLICABLE FINANCIAL HARDSHIP PROVISIONS 12.1 The Provider or the Resident may apply to the Secretary for a determination under section 52

K-1 of the Act that the Resident must not be charged an Accommodation Payment or an Accommodation Contribution more than the amount specified in the determination because payment of more than that amount would cause the Resident financial hardship. The specified amount may be nil.

12.2 If an Accommodation Payment or an Accommodation Contribution is not paid because the Provider or the Resident has applied to the Secretary for a determination under section 52 K-1 of the Act, as detailed in 12.1, then the amount of the Accommodation Payment or the Accommodation Contribution specified in the Main Details shall be payable by the Resident:

(a) if the Secretary declines to make the determination, or

(b) the determination is made but later ceases to be in force.

RESIDENT AGREEMENT


13. PRUDENTIAL REQUIREMENTS 13.1 In accordance with the Act, any Refundable Deposit paid by the Resident will be protected

by the specific Prudential Arrangements approved of by the Secretary to the Department pursuant to Part 5 of the Fees and Payments Principles 2014.

13.2 The Prudential Arrangements applicable to the Resident’s Refundable Deposit are shown

below:

(a) The funds are able to be used for aged care related purposes which are specified in s52N-1 of the Act.

(b) The Provider guarantees repayment of the Refundable Deposit Balance within the timeframes specified in the Act and detailed in full in Clause 9 of this Schedule.

(c) The Provider guarantees that it has, throughout each year, enough insurance to cover losses arising from fraud, loss of earnings, fire, flood or other reasonably insurable events that may affect the ability of the Provider to refund Refundable Deposit Balances.

(d) Within four (4) months of the end of each financial year for the Provider, the Provider will prepare a written statement (the Annual Prudential Compliance Statement) that must state:

(i) the total number of Refundable Deposit Balances held by the Provider as at the end of the financial year

(ii) the total value of Refundable Deposit Balances held by the Provider as at the end of the financial year

(iii) the total value of Refundable Deposit Balances received by the Provider during the financial year

(iv) the total amount deducted by the Provider from Refundable Deposit Balances during the financial year

(v) the total amount deducted by the Provider from Refundable Deposits received during the financial year

(vi) the total value of Refundable Deposit Balances refunded by the Provider during the financial year

(vii) if, during the financial year, Refundable Deposit Balances were not refunded in accordance with the Act

(viii) if, for the whole or part of the financial year, the Provider was not permitted to charge a Refundable Deposit

(ix) the use of Refundable Deposit by the Provider during the financial year

(x) whether any use of Refundable Deposit by the Provider during the financial year was not permitted under the Act

(xi) the total amount of Refundable Deposits expended by the Provider during the financial year on capital expenditure permitted under the Act

(xii) the total amount of Refundable Deposits expended by the Provider during the financial year on financial products permitted under the Act

(xiii) the total amount of Refundable Deposits expended by the Provider during the financial year on loans permitted under the Act

(xiv) the total amount expended by the Provider during the financial year (whether or not obtained from Refundable Deposits) on repaying debt accrued for permitted capital expenditure or refunding Refundable Deposit Balances

(xv) the total amount expended by the Provider during the financial year (whether or not obtained from Refundable Deposits) on repaying debt that accrued before 1 Oct 2011 for the purpose of providing aged care

RESIDENT AGREEMENT


(xvi) the total amount expended by the Provider during the financial year (whether or not obtained from Refundable Deposits) on meeting businesses losses permitted under the Act

(xvii) the amount that has been returned to the Provider during the financial year from the sale, disposal or redemption of financial products permitted under the Act that were invested in after 1 Oct 2011, whether or not the investment was obtained from Refundable Deposits

(xviii) the Provider's minimum level of liquidity as at the end of the financial year

(xix) any other information determined by the Secretary

(xx) whether the Provider has, during the year, complied with the Liquidity Standard; the Records Standard; the Governance Standard; and the Disclosure Standard (detailed below)

(xxi) if the approved provider has not complied with the Records Standard, a statement detailing the reasons for such

(xxii) if the Provider has not complied with the Governance Standard;, a statement detailing the reasons for such

(xxiii) if the Provider has not complied with the Disclosure Standard, a statement detailing the reasons for such that includes the total number of occasions and the total number of non-compliance attributable to each stated reason

(xxiv) an audit opinion on whether the Provider has complied with the Prudential Requirements of Part 5 of the Fees and Payments Principles 2014 (No.2) in the relevant financial year.

(e) The statement will be signed off by the company directors or otherwise by a member of the group of people who are responsible for the Provider’s executive decisions;

(f) The statement will also be certified, or qualified as appropriate, by an independent auditor or accountant;

(g) Within four (4) months after the end of financial year the Provider will send a copy of the certified statement to the state office of the Department.

The Liquidity Standard The Provider is required to:

(a) have sufficient liquidity to ensure that they can refund Refundable Deposits as they fall due

(b) implement and maintain a written liquidity management strategy that identifies

(i) the amount required to ensure that the Provider has sufficient liquidity to refund Refundable Deposit Balances, Accommodation Bond Balances and Entry Contributions Balances as they fall due in the following 12 months;

(ii) the factors that the Provider had regard to in determining the minimum level of liquidity; and

(iii) the form(s) in which the Provider will maintain minimum levels of liquidity.

(c) maintain the minimum level of liquidity detailed in the Provider’s liquidity management strategy in the form that the Provider has stated.

RESIDENT AGREEMENT


Records Standard (Refundable Deposits register) Providers are required to develop and maintain a Refundable Deposit register that will include information about all Refundable Deposits, accommodation bonds and entry contributions held by the Provider. The requirements for Refundable Deposit register entries are only for lump sum amounts. If a Resident has paid the Accommodation Payment partly by Refundable Deposit and partly by Daily Payments, an entry on the Refundable Deposit register must be made for the Refundable Deposit component of the Accommodation Payment. The Refundable Deposit register should include:

• Resident details • Refundable Deposit details • Deductions • The Refundable Deposit Balance as at the end of each calendar month in respect of each

Resident • Refund of Refundable Deposits under section 73 of the Fees and Payment Principles 2014 • All other required under Division 3 of Part 5 of the Fees and Payment Principles 2014.

Governance Standard Providers that hold one or more Refundable Deposits Balances must implement and maintain a governance system that ensures Refundable Deposits Balances are used only for permitted uses and are refunded in accordance with the Act. The governance system must:

(a) allocate responsibilities to the key personnel responsible for managing Refundable Deposits Balances;

(b) monitor and control any delegation or outsourcing of these responsibilities;

(c) have reporting mechanisms to ensure responsible key personnel can monitor and control the use of Refundable Deposits;

(d) ensure that responsible key personnel are aware of the legislative requirements in relation to Refundable Deposits; and

(e) detect, record and respond to any non-compliance.

The Provider must:

(a) keep written documentation describing the governance system (b) ensure that the written documentation of the governance system is up to date (c) modify or replace the governance system if it is identified that the system no longer complies

with legislative requirements.

RESIDENT AGREEMENT


Investment Management Strategy To comply with the Governance Standard, if the Provider is investing in financial products other than a deposit facility (made available by an authorised deposit-taking institution (ADI) – a list of which can be found at http://www.apra.gov.au/adi/pages/adilist.aspx), the Provider must implement and maintain an investment management strategy (IMS). The aim of an IMS is to ensure that the Provider has arrangements in place to make informed and prudent decisions on the investment of Refundable Deposits; to assess the risks of financial investments, including our liquidity and obligation to refund Refundable Deposits and respond to changing risk. The Provider must document an IMS that:

(a) sets out the Provider’s investment objectives (b) sets out the Provider’s assessment of the level of risk to their ability to refund Refundable

Deposits in accordance with the Act (c) details a strategy to achieve these objectives whilst ensuring the ability to refund Refundable

Deposits in accordance with the Act (d) specifies the asset classes the Provider may invest in and the investment limits for each asset

class (e) is approved by the key personnel who are responsible for the Provider’s executive decisions.

The Provider must ensure that any investment of Refundable Deposits is in accordance with the IMS.

The Provider is responsible for both keeping the IMS up‐to‐date, and for modifying or replacing strategies that do not comply with the requirements.

Disclosure Standard The Provider is required to provide the following information:

On entry

Within seven (7) days of entering into the Agreement, the Provider must provide the Resident or their representative with:

(a) a copy of the Accommodation agreement

(b) a written guarantee of refund of the a Refundable Deposit Balance

(c) a written statement explaining what other information is available on request — see the Disclosure Statement, below, for a statement that the Department considers to be compliant with this requirement. This information must be provided within seven (7) days of the request

Annually Within four (4) months of the end of the financial year, the Provider must provide each Resident or their representative with:

(a) a copy of the resident’s entry in the Refundable Deposit register

(b) a written statement explaining what other information is available on request — see the Disclosure Statement, below, for a statement that the Department considers to be compliant with this requirement.

RESIDENT AGREEMENT


On request

Within seven (7) days of a request being made, the Provider is required to provide the following information to residents, prospective residents or their families:

(a) a summary of the permitted uses that Refundable Deposits have been used for in the previous financial year

(b) if Refundable Deposits have been invested in financial products other than through authorised deposit taking institutions, a statement explaining the Provider’s investment objectives and the asset classes they may invest in

(c) information about whether the Provider has complied with the prudential requirements and permitted uses for Refundable Deposits.

(d) a copy of the independent audit opinion of the Annual Prudential Compliance Statement (APCS) from the previous financial year

(e) information about the number of Refundable Deposits Balances that were not refunded in accordance with the Aged Care Act 1997 (the Act) or, for entry contributions, a formal agreement

(f) the most recent audited accounts or, if the service is part of a broader organisation, the statement relating to the aged care component

(g) (if the resident has already paid a Refundable Deposit) a copy of the resident’s entry in the Refundable Deposit register, current at the time of the request.

DISCLOSURE STATEMENT This statement is taken by the Australian Government Department of Social Services to be a statement that complies with Section 57 of the Fees and Payment Principles 2014. We are the approved provider for this service. Under the Aged Care Act 1997 (the Act), residents and prospective residents or their representatives are entitled to receive particular information from us on request. This includes, in relation to the previous financial year:

(a) a summary of the permitted uses for which we have used Refundable Deposits and Accommodation Bonds

(b) information about whether we complied with the requirements for permitted uses of Refundable Deposits and Accommodation Bonds and with the prudential requirements for Refundable Deposits and Accommodation Bonds

(c) information about the number of Refundable Deposits Balances and Accommodation Bond Balances (if any) that were not refunded in accordance with the timeframes set by the Act. For entry contributions (payable before 1997), information about the number (if any) that were not refunded in accordance with the entry contribution agreement

(d) a copy of the independent audit opinion on our compliance with the prudential requirements for Refundable Deposits, Accommodation Bonds and Entry Contributions

(e) our most recent statement of audited accounts

(f) if you have already paid a Refundable Deposit, a copy of your entry in the Refundable Deposits register

(g) if we invest Refundable Deposits and Accommodation Bonds in particular kinds of permitted financial products, our investment objectives and the asset classes we may invest in.

Residents, prospective residents or their representatives may request any or all of the available information. We must provide the information within seven (7) days of the request, and the information must be correct at the time of the request.

RESIDENT AGREEMENT


SCHEDULE 5 - EXTRA SERVICES LIST OF ACCOMMODATION, FOOD & SERVICES

Clause 21.1

1 ACCOMMODATION – principles A range of accommodation and furnishing choices is available to residents in well maintained buildings and grounds that meet, or are being refurbished to meet, requirements of the 2008 certification standards for new buildings as a minimum. Choices of recreational and communal spaces are available to support varying interactions in an atmosphere that is comfortably social and homelike. Furniture, furnishings and fittings are of a superior standard and indicate that professional attention has been given to the nature of the fittings, the use of a consistent style or styles and the creation of appropriate colour schemes. 1.1 Accommodation - building standards

The building (or Extra Service part) meets or exceeds 2008 certification standards for new buildings

1.2 Accommodation – features

Individual single rooms have an average floor area of 16m² or more (excluding ensuite)

Provision of toilets and showers over and above the ratios for 2008 certification requirements

More than 50% of rooms are private single rooms, with options for shared rooms at the request of residents, subject to availability

Heating and cooling systems for residents’ rooms that are individually controllable by the resident or staff Internal lounge /dining / sitting rooms at a minimum ratio of 1 per 10 residents

At least one private function/dining room for residents and visitors, separate from main dining area(s)

Natural light and vistas to a majority of residents' rooms

Courtyards, balconies or verandahs accessible to a majority of residents

Substantial landscaped gardens, readily accessible to residents, including residents with mobility aids

Professionally landscaped, secure gardens designed for people living with dementia

1.3 Accommodation - furniture and fittings

Colour coordinated decor and quality fittings. Includes quality furniture, maintained to a high standard, comparable to furniture found in people's homes, e.g. mantelpieces/fireplaces, pianos, display cupboards, occasional tables, hall tables etc.

Superior quality floor coverings (e.g. carpet, cushion back vinyl) in common areas and residents' rooms Tea and coffee making facilities provided in residents' rooms, when requested and appropriate TV connection capability provided in all residents' rooms

Phone connection capability provided in all residents' rooms

Computer connection capability provided to all residents’ rooms

Sufficient dedicated power points for appliances in residents’ rooms (with a minimum of four power sockets)

Electric adjustable bed provided for any resident who requests it

1.4 Accommodation – innovations and special features

All rooms are single with private ensuite with heating lamps and sky light

All rooms have their own fully enclosed patio with tinted glass windows and al fresco furnishings

RESIDENT AGREEMENT


2. FOOD – principles

2.1 Food Choice of at least 2 main courses plus entrée/soup and/or a choice of desserts at lunch and dinner

BBQs / special occasion meals provided over and above routine social and cultural meals and events provided as part of Specified Care and Services or claimable under the Resident Classification Scale

All meals are prepared by chef or cook on site. Superior quality cuts and ingredients, fresh vegetables etc are consistently used.

Choice of dining venues: in resident's own room, other room or dining rooms as requested by resident

Residents can exercise choice of time for breakfast, lunch and dinner (each meal available for at least 1.5 hours) Meals available for guests on request (at small cost)

Selection of snacks and non-alcoholic beverages available 24 hours / day (additional to water, tea/coffee, juices, fruit, biscuits)

2.2 Food - innovations and special features

High Teas: a silver service afternoon tea is served each fortnight, with special food treats and a selection of teas.

Fully equipped kitchenette for use by residents and their guests at any time Special Birthday morning teas: monthly celebration of residents’ birthdays, with birthday cake, gourmet sandwiches &

savouries, and congratulatory cards.

3. SERVICES – principles

Residents are able to select from a wide range of lifestyle and interest activities and personal services, over and above their assessed care needs. Individual residents' choices and preferences are respected and residents are consulted about changes or innovations in services they would like. In conjunction with the regular review of each resident’s health status and care plan, and within the overall set of services available, each resident is offered the opportunity to re-align the services they receive to their changing lifestyle.

3.1 Services- lifestyle and interests

Note: Each service below is to be provided at no additional cost to the resident unless a specific note about cost is included in the description.

One or more large screen TV with video / DVD in a lounge area, with no cable/satellite TV.

Provision of telephone handset to each resident’s room

Substantial DVD / video library, with regular updating of stock and/or library of at least 100 books available, in good condition, and suitable for residents to read, including large print books.

Private gardening areas / garden beds for residents, including areas in gardens specifically designed for persons living with dementia, with raised beds available and some plants

Separate external buildings available for residents’ leisure activities, e.g. workshop, garden shed, gazebo – pergola area

* Activities offered to residents as additional choices that are available to them as individuals. These are to be over and above activities that are either: - routine in-house group or individual activities provided as part of Specified Care and Services; or

- activities provided to meet the resident's assessed care needs.

News & Views Current Affairs Group: meets weekly over morning tea/coffee to discuss topical issues gleaned from the newspapers, Internet, television news etc.

RESIDENT AGREEMENT


* Outings offered to residents as additional choices that are available to them as individuals. These are to be over and above outings that are either: - routine in-house group or individual outings provided as part of Specified Care and Services; or

- outings that are provided to meet the resident's assessed care needs.

Residents may be asked to pay for the cost of admission to events or venues.

Fortnightly outings to a variety of local attractions, special events, local clubs for lunch etc.

Provision of dedicated bus fitted appropriately for the transport of residents

3.2 SERVICES - enhanced personal services

* Additional personal grooming and beauty services (e.g. facials, manicures) chosen by the resident for personal enjoyment. These are to be over and above services that are either: - routine services provided as part of Specified Care and Services; or

- services that are provided to meet the resident's assessed care needs. Resident to pay for cost of the service.

Facials: Qualified beautician to treat the ladies to facials (at resident cost)

Manicures by qualified nail technician (at resident cost)

Waxing treatment by local beautician (at resident cost) Additional elective tactile or massage services chosen by the resident for personal enjoyment. These are to be over and

above services that are either: - routine services provided as part of Specified Care and Services; or

- services that are provided to meet the resident's assessed care needs. Resident to pay for cost of the service.

Sensory stimulation sessions: One-on-one sessions involving a range of activities to relax and stimulate the senses, which may include aromatherapy, music, coloured lights etc. (at resident cost)

Reflexology treatment available by trained practitioner (at resident cost)

Massage: Monthly availability of full body massage by contracted, qualified masseuse (at resident cost and subject to suitability assessment)

Provision of escort to outside appointments, as requested by resident or family (at resident cost)

3.3 Services - innovations, culture of service and special features

Personal Shopping Services: in addition to scheduled shopping excursions, once per month, residents are assisted to compile shopping lists for personal items that one of our staff shops for on their behalf.

A computer is available with Internet access for resident use at any time.

MATV and CCTV is available in all residents’ rooms to enable them to view in-house videos, or talks or concerts broadcast from the Activity Room.

Residents can make use of the Reflection/Meditation room at any time.

RESIDENT AGREEMENT


SCHEDULE 6 - EXTRA SERVICE FEE

Clause 21.7

Room type Eg single, double, ensuite

Number of Extra Service Rooms in this room type

Total number of Extra Services places in this

room type

Extra Service Fee per place ($/day)

Single, ensuite 37 37 $10.00

RESIDENT AGREEMENT


SCHEDULE 7 – SPECIAL CONDITIONS

Clause 23.1

(Here add any special conditions - if none write "NIL")

RESIDENT AGREEMENT


ATTACHMENT ONE – MOVES WITHIN THE CARE FACILITY

Clause 5.4 and Clause 6.5 (1) If the Resident moves to another Room (the New Room), or to another part (the New Part) of a Room, in

the Care Facility on a day:

(a) the Resident is not taken to have entered the Care Facility on that day; and

(b) the Act (in particular in respect of arrangements for Date of Entry) continues to apply in relation to the Resident by reference to the Resident’s original Date of Entry to the Care Facility.

Additional matters in relation to voluntary moves within the Care Facility

(2) If the Resident proposes to move to a new Room, or to a New Part of a Room, in the Care Facility, and the move is voluntary:

(a) the Accommodation Agreement must be varied, before the move occurs, to specify the new Room or the New Part of the Room; and

(b) the day on which the Agreement is varied will become the Price Agreement Day for the Resident; and

(c) the Resident will be charged an Accommodation Payment amount, after the move, that may be higher or lower than the Accommodation Payment amount the Resident is paying before the move and will be the Accommodation Payment that was made publicly available by the Provider for the Resident’s new Price Agreement Day and the new Room or the New Part of the Room; and

(d) if the Resident is to be charged a higher Accommodation Payment amount for the new Room or the New Part of the Room—the Resident may choose to pay the additional Accommodation Payment amount by:

(i) Daily Payments; or

(ii) Refundable Deposit; or

(iii) a combination of Refundable Deposit and Daily Payments.

Additional matters in relation to non-voluntary moves within the Care Facility

(3) If the Resident is to be moved to a new Room, or to a New Part of a Room, in the Care Facility for less than 28 days, and the move is not voluntary:

(a) the Provider must, before the move occurs, notify the Resident, in writing, of the new Room or the New Part of the Room; and

(b) there will be no change to the Resident’s Price Agreement Day; and

(c) the Resident will continue to be charged the same Accommodation Payment amount that the Resident is paying before the move.

(4) If the Resident is to be moved to a new Room, or to a New Part of a Room, in the Care Facility for 28 days or longer, and the move is not voluntary:

(a) the Provider must, before the move occurs, notify the Resident, in writing, of the new Room or the New Part of the Room; and

(b) the day on which the notice is given will become the Price Agreement Day for the Resident; and

RESIDENT AGREEMENT


(c) the Resident must not be charged:

(i) an Accommodation Payment amount that is higher than the Accommodation Payment amount the Resident is paying before the move; or

(ii) if the Provider’s published maximum Accommodation Payment amount that was made publicly available by the Provider for the Resident’s new Price Agreement Day and the New Room, or the New Part of the Room, is lower than the amount the Resident is paying before the move then the Provider will charge the lower Accommodation Payment from the new Price Agreement Day.

(5) For subsections (3) and (4), a move by a Resident to a new Room, or to a New Part of a Room, in the Care Facility is not voluntary if:

(a) the move is necessary on genuine medical grounds as assessed by:

(i) The Aged Care Assessment Team; or

(ii) at least 2 medical or other health practitioners who meet the criteria mentioned in subsection (6); or

(b) the place occupied by the Resident becomes an Extra Service place and the Resident elects not to pay the Extra Service Fee; or

(c) the move is necessary to carry out repairs or improvements to the premises of the Care Facility.

(6) For subparagraph (5)(a)(ii), the criteria are:

(a) one practitioner must be independent of the Provider and the Care Facility, and must be chosen by the Resident; and

(b) both practitioners must be competent to assess the aged care needs of the Resident.

RESIDENT AGREEMENT


ATTACHMENT TWO – AGED CARE COMPLAINTS SCHEME

(Residential Care Agreement, Clause 17.8)

Website: http://agedcarecomplaints.govspace.gov.au

New South Wales

Aged Care Complaints Scheme Department of Social Services GPO Box 9820 SYDNEY NSW 2001 (letters can be anonymous or marked ‘Confidential’) Toll-free: 1800 550 552

Western Australia

Aged Care Complaints Scheme Department of Social Services GPO Box 9820 PERTH WA 6001 (letters can be anonymous or marked ‘Confidential’) Toll-free: 1800 550 552

Victoria

Aged Care Complaints Scheme Department of Social Services GPO Box 9820 MELBOURNE VIC 3001 (letters can be anonymous or marked ‘Confidential’) Toll-free: 1800 550 552

Tasmania

Aged Care Complaints Scheme Department of Social Services GPO Box 9820 HOBART TAS 7000 (letters can be anonymous or marked ‘Confidential’) Toll-free: 1800 550 552

Queensland

Central and South Queensland

Aged Care Complaints Scheme Department of Social Services GPO Box 9820 BRISBANE QLD 4001 (letters can be anonymous or marked ‘Confidential’) Toll-free: 1800 550 552

Northern Territory

Darwin

Aged Care Complaints Scheme Department of Social Services GPO Box 9820 DARWIN NT 0800 (letters can be anonymous or marked ‘Confidential’) Toll-free: 1800 550 552

North Queensland

Aged Care Complaints Scheme Department of Social Services PO Box 2018 TOWNSVILLE QLD 4810 (letters can be anonymous or marked ‘Confidential’) Toll-free: 1800 550 552

Alice Springs

The Regional Manager Department of Social Services P O Box 8091 ALICE SPRINGS NT 0871 (letters can be anonymous or marked ‘Confidential’) Toll-free: 1800 550 552

South Australia

Aged Care Complaints Scheme Department of Social Services GPO Box 9820 ADELAIDE SA 5001 (letters can be anonymous or marked ‘Confidential’) Toll-free: 1800 550 552

Australian Capital Territory

Aged Care Complaints Scheme Department of Social Services GPO Box 9820 CANBERRA ACT 2601 (letters can be anonymous or marked ‘Confidential’) Toll-free: 1800 550 552

RESIDENT AGREEMENT


ATTACHMENT THREE – ADVOCACY SERVICES

(Residential Care Agreement, Clause 17.4 and Clause 17.9)

New South Wales

The Aged-Care Rights Service Level 4, 418A Elizabeth Street SURRY HILLS NSW 2010 Phone: (02) 9281 3600 or 1800 424 079 (freecall) Email: [email protected] Website: www.tars.com.au Victoria

Elder Rights Advocacy Level 2 85 Queen Street MELBOURNE VIC 3000 Phone: (03) 9602 3066 or 1800 700 600 (freecall) Email: [email protected] Website: www.era.asn.au Queensland

QLD Aged & Disability Advocacy Inc. Toll-free: 1800 818 338

Brisbane (Head office) 121 Copperfield Street GEEBUNG QLD 4034 Phone: (07) 3637 6000 Fax: (07) 3637 6001 E-mail: [email protected] Website: www.qada.org.au

Cairns PO Box 361 Bungalow QLD 4870 Fax: 07 4041 1826

Gold Coast PO Box 325 Varsity Lakes QLD 4227 Fax: 07 5522 1911

Hervey Bay PO Box 5628 Hervey Bay QLD 4655 Fax: 07 4191 4982

Mackay PO Box 9186 Slade Point QLD 4740 Fax: 07 4942 0940

Rockhampton PO Box 8418 Allenstown QLD 4700 Fax: 07 4927 9411

Toowoomba PO Box 1289 Toowoomba QLD 4350 Fax: 07 4637 9499

Townsville PO Box 245 Thuringowa Central QLD 4817 Fax: 07 4723 4856

South Australia

Aged Rights Advocacy Service Inc. 16 Hutt Street (PO Box 7234) ADELAIDE SA 5000 Phone: (08) 8232 5377 or 1800 802 030 (freecall) Email: [email protected] Website: www.sa.agedrights.asn.au/ Western Australia

Advocare Inc. Unit 1/190 Abernethy Road BELMONT WA 6104 Phone: (08) 9479 7566 or 1800 655 566 (freecall) Email: [email protected] Website: www.advocare.org.au Tasmania

Advocacy Tasmania Inc Suite 6, Mayfair Plaza (PO Box 426) 236-244 Sandy Bay Road SANDY BAY TAS 7006 Phone: (03) 6224 2240 or 1800 005 131(freecall) Email: [email protected] Website: www.advocacytasmania.org.au Northern Territory

Darwin Darwin Community Legal Service Aged/Disability Rights 8 Manton Street (GPO Box 3180) DARWIN NT 0801 Phone: (08) 8982 1111 or 1800 812 953 (freecall) Email: [email protected] Website: www.dcls.org.au

Alice Springs CatholicCare NT 6 Hartley Street ALICE SPRINGS NT 0871 Phone: (08) 8958 2400 or 1800 354 550 (freecall) Email: [email protected] Website: www.catholiccarent.org.au Australian Capital Territory

ACT Disability, Aged and Carer Advocacy Service (ADACAS) Suite 104, Block C Canberra Technology Park Phillip Avenue WATSON ACT 2602 (Postal: PO Box 144, DICKSON ACT 2602)

Phone: (02) 6242 5060 or 1800 700 600 (freecall) Email: [email protected] Website: www.adacas.org.au

RESIDENT AGREEMENT



RESIDENT AGREEMENT


ATTACHMENT FOUR

“Declaration of Having Sufficient Assets to be Levied an Accommodation Payment” (Schedule Four, Clause 1.2 (a))

To: The Provider

I, Mr/Mrs/Ms wish to be admitted to, and be provided with residential care through, the Care Facility. I understand that, if I have a minimum of $155,823.20 in assets, I will be assessed as able to pay an Accommodation Payment. I do not wish to provide to you information concerning the value of my assets which information I acknowledge and agree is essential for you to know if you are to have sufficient information about my assets to work out my status. I understand that, if I have assets of less than $155,823.20, I may be eligible to be considered a Low-means Resident and may be eligible to pay a lower amount (an Accommodation Contribution) or nil in lieu of an Accommodation Payment. I understand how the tests operate to determine whether I have sufficient assets to pay the Accommodation Payment for my Room and I warrant to you that I have a minimum of $155,823.20 in assets. I confirm that I understand that you will, therefore, charge me the Accommodation Payment applicable to my Room, which I can elect to pay as a Refundable Deposit, Daily Payments or a combination of the two, that I shall pay in addition to all other fees and charges payable by me to you. I also understand that I must be left with a minimum of $45,500 in assets after paying the Accommodation Payment by full or partial Refundable Deposit. I understand that the Care Facility is required by legislation to accommodate a minimum proportion of Low-means Residents. Accordingly, the Care Facility is required to have regard to the level of financial capacity of new Residents before entry. SIGNED: Resident: ___________________________ Date : OR Signed by the Resident by being signed by his/her Representative: ____________________________ Date: Important Notes: 1. Whether you are entering residential care for the first time or transferring from another service, your calculation of

total assets must include any gifts you have made. The “allowable amount” to gift is $10,000 in a single financial year, or $30,000 in a five year financial period

2. A person with high income levels may be assessed as not being a Low-means Resident even if their assets are below $155,823.20

RESIDENT AGREEMENT

Jan 2015 Page 71 © 2015 James Underwood & Associates Pty Ltd

ATTACHMENT FOUR

“Declaration of Having Sufficient Income to be Levied an Accommodation Payment” (Schedule Four, Clause 1.2 (a))

To: The Provider

I, Mr/Mrs/Ms wish to be admitted to, and be provided with residential care through, the Care Facility. I understand that, if I have a minimum of $63,731.72 in annual income, I may be assessed as able to pay an Accommodation Payment. I do not wish to provide to you information concerning the value of my assets which information I acknowledge and agree is essential for you to know if you are to have sufficient information about my assets to work out my status. I understand that, if I have an annual income of less than of $63,731.72, I may be eligible to be considered a Low-means Resident and may be eligible to pay a lower amount (an Accommodation Contribution) or nil in lieu of an Accommodation Payment. I understand how the tests operate to determine whether I have sufficient income to pay the Accommodation Payment for my Room and I warrant to you that I have a minimum of $63,731.72 in annual income. I confirm that I understand that you will, therefore, charge me the Accommodation Payment applicable to my Room, which I can elect to pay as a Refundable Deposit, Daily Payments or a combination of the two, that I shall pay in addition to all other fees and charges payable by me to you. I also understand that I must be left with a minimum of $45,500 in assets after paying the Accommodation Payment by full or partial Refundable Deposit. I understand that the Care Facility is required by legislation to accommodate a minimum proportion of Low-means Residents. Accordingly, the Care Facility is required to have regard to the level of financial capacity of new Residents before entry. SIGNED: Resident: ___________________________ Date : OR Signed by the Resident by being signed by his/her Representative: ____________________________ Date: Important Notes: 1. Whether you are entering residential care for the first time or transferring from another service, your calculation of

total assets must include any gifts you have made. The “allowable amount” to gift is $10,000 in a single financial year, or $30,000 in a five year financial period

2. A person with levels of assets above $45,500 may be assessed as not being a Low-means Resident even if their income is below $63,731.72

RESIDENT AGREEMENT


ATTACHMENT FOUR

“Provision of DHS/DVA Assessment of Being a Low-Means Resident” (Schedule Four, Clause 1.2(a) or Clause 8)

To: The Provider

I, Mr/Mrs/Ms wish to be admitted to, and be provided with residential care through, the Care Facility.

A Copy of a current DHS/DVA advice has been given to the Provider. This DHS/DVA advice details that I am

a Low-means Resident or Low-means Care Recipient.

SIGNED: Resident: ___________________________ Date: OR Signed by the Resident by being signed by his/her Representative: ____________________________ Date:

RESIDENT AGREEMENT


ATTACHMENT FOUR

“Provision of DHS/DVA Assessment of Being a Low-Means Resident Pending” (Schedule Four, Clause 1.2(a) or Clause 8)

To: The Provider

I, Mr/Mrs/Ms wish to be admitted to, and be provided with residential care through, the Care Facility. A Copy of a current DHS/DVA advice has not yet been given to the Provider. I am currently awaiting a response from DSS/DVA. I advise that the DHS/DVA advice will detail that I am a Low-means Resident or Low-means Care Recipient. I understand that I may still be subject to an Accommodation Contribution, based on my level of assets and income. Should the DHS/DVA advice state that I am not a Low-means resident, I understand that the applicable Accommodation Payment will be payable for my room in lieu of an Accommodation Contribution. SIGNED: Resident: ___________________________ Date: OR Signed by the Resident by being signed by his/her Representative: ____________________________ Date:

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